title: Compressive cryotherapy versus ice-a prospective, randomized study on postoperative pain in patients undergoing arthroscopic rotator cuff repair or subacromial decompression.
abstract: BACKGROUND
  The purpose of this study was to compare the effect of compressive cryotherapy (CC) vs. ice on postoperative pain in patients undergoing shoulder arthroscopy for rotator cuff repair or subacromial decompression. A commercial device was used for postoperative CC. A standard ice wrap (IW) was used for postoperative cryotherapy alone.
  
  
  METHODS
  Patients scheduled for rotator cuff repair or subacromial decompression were consented and randomized to 1 of 2 groups; patients were randomized to use either CC or a standard IW for the first postoperative week. All patients were asked to complete a "diary" each day, which included visual analog scale scores based on average daily pain and worst daily pain as well as total pain medication usage. Pain medications were then converted to a morphine equivalent dosage.
  
  
  RESULTS
  Forty-six patients completed the study and were available for analysis; 25 patients were randomized to CC and 21 patients were randomized to standard IW. No significant differences were found in average pain, worst pain, or morphine equivalent dosage on any day.
  
  
  CONCLUSIONS
  There does not appear to be a significant benefit to use of CC over standard IW in patients undergoing shoulder arthroscopy for rotator cuff repair or subacromial decompression. Further study is needed to determine if CC devices are a cost-effective option for postoperative pain management in this population of patients.
authors.affiliation: Department of Orthopaedic Surgery, CU Sports Medicine, Boulder, CO, USA. Electronic address: mjk8x@virginia.edu.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Kraeutler
authors.affiliation: Department of Orthopaedic Surgery, CU Sports Medicine, Boulder, CO, USA.
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Reynolds
authors.affiliation: Department of Orthopaedic Surgery, CU Sports Medicine, Boulder, CO, USA.
authors.forename: Cyndi
authors.initials: C
authors.lastname: Long
authors.affiliation: Department of Orthopaedic Surgery, CU Sports Medicine, Boulder, CO, USA.
authors.forename: Eric C
authors.initials: EC
authors.lastname: McCarty
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects*; D017679:Cryotherapy / Q000379:methods*; D019299:Decompression, Surgical / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007053:Ice; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies; D017006:Rotator Cuff / Q000601:surgery*
chemical_list: D007053:Ice
keywords: Compressive cryotherapy; cold compression; cryotherapy; morphine equivalent dosage; postoperative pain; rotator cuff repair; shoulder arthroscopy; subacromial decompression