Effectiveness and safety of cryotherapy after arthroscopic anterior cruciate ligament reconstruction. A systematic review of the literature.
Cryotherapy is widely used in rehabilitation; however, its effectiveness after anterior cruciate ligament (ACL) reconstruction remains uncertain. To investigate the effectiveness and safety of cryotherapy following ACL reconstruction through a systematic review, randomized and quasi-randomized clinical trials were searched in the databases: MEDLINE, EMBASE, CENTRAL, PEDro, SportDiscus, CINAHL, LILACS (June 2013). The primary outcomes measures were pain, edema and adverse events; the secondary outcomes were knee function, analgesic medication use, range of motion, blood loss, hospital stay, quality of life and patient satisfaction. The methodological quality of studies was evaluated using the Cochrane Collaboration risk-of-bias tool. Ten trials (a total of 573 patients) were included. Results of meta-analysis showed that the use of cold compression devices produced a significant reduction in pain scores 48 h after surgery (p < 0.00001), compared to no cryotherapy. The risk for adverse events did not differ between patients receiving cryotherapy versus no treatment (p = 1.00). The limited evidence currently available is insufficient to draw definitive conclusions on the effectiveness of cryotherapy for other outcomes. There is a need for well designed, good quality randomized trials to answer other questions related to this intervention and increase the precision of future systematic reviews.
Department of Internal Medicine, Federal University of Sao Paulo, Rua Botucatu, 740, 04023-900 São Paulo, SP, Brazil. Electronic address: analuizacabrera@hotmail.com.
Ana Luiza Cabrera
AL
Martimbianco
Department of Internal Medicine, Federal University of Sao Paulo, Rua Botucatu, 740, 04023-900 São Paulo, SP, Brazil.
Brenda Nazaré
BN
Gomes da Silva
Department of Internal Medicine, Federal University of Sao Paulo, Rua Botucatu, 740, 04023-900 São Paulo, SP, Brazil.
Alan Pedrosa Viegas
AP
de Carvalho
Department of Internal Medicine, Federal University of Sao Paulo, Rua Botucatu, 740, 04023-900 São Paulo, SP, Brazil.
Valter
V
Silva
Department of Internal Medicine, Federal University of Sao Paulo, Rua Botucatu, 740, 04023-900 São Paulo, SP, Brazil.
Maria Regina
MR
Torloni
Department of Internal Medicine, Federal University of Sao Paulo, Rua Botucatu, 740, 04023-900 São Paulo, SP, Brazil.
Maria Stella
MS
Peccin
D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods / Q000534:rehabilitation*; D001182:Arthroscopy; D017679:Cryotherapy / Q000379:methods; D006801:Humans; D007718:Knee Injuries / Q000534:rehabilitation / Q000601:surgery; D010149:Postoperative Pain / Q000517:prevention & control* / Q000534:rehabilitation; D016896:Treatment Outcome
Anterior cruciate ligament; Anterior cruciate ligament reconstruction; Cold therapy; Cryotherapy