Authors’ Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.
Ms. Piana is a Medical Student, University of Tennessee, College of Medicine, Memphis, Tennessee. Ms. Garvey is a Research Assistant, Women’s Sports Medicine, Brigham and Women’s Hospital, Boston, Massachusetts. Ms. Burns was an undergraduate student, Hobart and William Smith Colleges, Geneva, New York. Dr. Matzkin is an Assistant Professor, Department of Orthopaedic Surgery, Harvard Medical School; and Chief of Women’s Sports Medicine, Brigham and Women’s Hospital, Boston, Massachusetts.
Address Correspondence to: Elizabeth G. Matzkin, MD, Brigham and Women’s Hospital, Department of Orthopaedic Surgery, 75 Francis Street, Boston, MA 02115 (tel, 617-525-8500; email, ematzkin@bwh.harvard.edu).
Lauren E. Piana, MS, BA Kirsten D. Garvey, MA, BA Halle Burns, BSElizabeth G. Matzkin, MD . The Cold, Hard Facts of Cryotherapy in Orthopedics . Am J Orthop.
September 12, 2018
TAKE-HOME POINTS
Cryotherapy is often used in postoperative orthopedic care but there is limited literature demonstrating its efficacy.
Postoperative cryotherapy has been used to reduce visual analog scale pain scores, analgesic consumption, and to increase range of motion.
There is no consensus on the advantages of postoperative cryotherapy vs traditional ice application.
Adverse outcomes from postoperative cryotherapy use include frostbite/skin loss, compartment syndrome, and perniosis.
Future studies, including a formidable economic analysis of advanced cold therapy systems are necessary before physicians prescribing cryotherapy can be confident that they are augmenting patient recovery.
References
ABSTRACT
Cryotherapy is the use of the anti-inflammatory and analgesic properties of ice to facilitate healing. Cryotherapy mediates these salutatory effects by reducing blood flow to the site of injury, down-regulating the production of inflammatory and pain-inducing prostaglandins, and diminishing the conductive ability of nerve endings. It is commonly used postoperatively in orthopedics to decrease analgesic requirements and blood loss as well as to increase range of motion, despite limited literature on its ability to produce such therapeutic effects in clinical practice. This article examines the available literature and the scientific evidence for the use and efficacy of cryotherapy in post-surgical orthopedic patients. It also reviews the potential pitfalls associated with improper use. Overall, this review seeks to provide insight into when, or whether, cryotherapy is appropriate for orthopedic patients during surgical recovery.
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