To investigate the effect of cryotherapy after elbow arthrolysis on elbow pain, blood loss, analgesic consumption, range of motion, and long-term elbow function.
Prospective, single-blinded, randomized controlled study.
Patients (N=59; 27 women, 32 men) who received elbow arthrolysis.
Patients were randomly assigned into a cryotherapy group (n=31, cryotherapy plus standard care) or a control group (n=28, standard care).
Main Outcome Measures
Elbow pain at rest and in motion were measured using a visual analog scale (VAS) on postoperative day (POD) 1 to POD 7 and at 2 weeks and 3 months after surgery. Blood loss and analgesic consumption were recorded postoperatively. Elbow range of motion (ROM) was measured before surgery and on POD 1, POD 7, and 3 months after surgery. The Mayo Elbow Performance Score (MEPS) was evaluated preoperatively and 3 months postoperatively.
VAS scores were significantly lower in the cryotherapy group during the first 7 PODs, both at rest and in motion (P<.05). There were no significant differences between the 2 groups in VAS scores at 2 weeks and 3 months after surgery. Less sufentanil was consumed by the cryotherapy group than the control group for pain relief (P<.01). No significant differences were found in blood loss, ROM, and MEPS between the 2 groups (P>.05).
Cryotherapy is effective in relieving pain and reducing analgesic consumption for patients received elbow arthrolysis. The application of cryotherapy will not affect blood loss, ROM, or elbow function.
List of abbreviations:MEPS (Mayo Elbow Performance Score), POD (postoperative day), ROM (range of motion), TKA (total knee arthroplasty), VAS (visual analog scale)
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- The posttraumatic stiff elbow: a review of the literature.J Hand Surg [Am]. 2007; 32: 1605-1623
- Posttraumatic elbow stiffness.J Hand Surg [Am]. 2012; 94: 1428-1437
- Surgical treatment of post-traumatic elbow stiffness: a systematic review.J Shoulder Elbow Surg. 2013; 22: 574-580
- Open arthrolysis and hinged external fixation for posttraumatic ankylosed elbows.Arch Orthop Trauma Surg. 2013; 133: 179-185
- Surgical treatment of elbow stiffness caused by post-traumatic heterotopic ossification.J Shoulder Elbow Surg. 2013; 22: 1128-1134
- Change in quality of life and cost/utility analysis in open stage-related surgical treatment of elbow stiffness.Orthopedics. 2013; 36: e923-e930
- Physical modalities in the treatment of tendon injuries.Clin Sports Med. 1992; 11: 645-659
- The effects of different dressings on the skin temperature of the knee during cryotherapy.Knee. 2005; 12: 21-23
- The effect of local cold application on intramuscular blood flow at rest and after running.Med Sci Sports Exerc. 1985; 17: 710-713
- The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner.Pain Physician. 2004; 7: 395-399
- The effect of submaximal exercise preceded by single whole-body cryotherapy on the markers of oxidative stress and inflammation in blood of volleyball players.Oxid Med Cell Longev. 2013; 2013: 409567
- Cryotherapy after total knee arthroplasty a systematic review and meta-analysis of randomized controlled trials.J Arthroplasty. 2010; 25: 709-715
- The efficacy of continuous cryotherapy on the postoperative shoulder: a prospective, randomized investigation.J Shoulder Elbow Surg. 2001; 10: 522-525
- Continuous local cooling for pain relief following total hip arthroplasty.J Arthroplasty. 2004; 19: 334-337
- Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow.J Hand Surg [Am]. 1992; 74: 479-490
- Continuous cold therapy in total knee arthroplasty.Am J Knee Surg. 1994; 8: 121-123
- Continuous-flow cold therapy after total knee arthroplasty.J Arthroplasty. 2002; 17: 718-722
- Cryo/Cuff compared to epidural anesthesia after knee unicompartmental arthroplasty: a prospective, randomized and controlled study of 60 patients with a 6-week follow-up.J Arthroplasty. 2005; 20: 316-321
- Postoperative cryotherapy after total knee arthroplasty: a prospective study of 86 patients.J Arthroplasty. 2006; 21: 1175-1179
- A randomized, controlled trial comparing compression bandaging and cold therapy in postoperative total knee replacement surgery.Orthop Nurs. 2002; 21: 61-62
- The efficacy of cryotherapy in the postoperative shoulder.J Shoulder Elbow Surg. 1996; 5: 62-68
- Cryotherapy does not impair shoulder joint position sense.Arch Phys Med Rehabil. 2004; 85: 1241-1246
- Standardized combined cryotherapy and compression using Cryo/Cuff after wrist arthroscopy.Knee Surg Sports Traumatol Arthrosc. 2011; 19: 314-319
- Hinged external fixator and open surgery for severe elbow stiffness with distal humeral nonunion.Orthopedics. 2013; 36: e186-e192
- Hyperbaric gaseous cryotherapy: effects on skin temperature and systemic vasoconstriction.Arch Phys Med Rehabil. 2007; 88: 1339-1343
- Acute Pain in the Elderly Study Group. Pain in the elderly: prospective study of hyperbaric CO2 cryotherapy (neurocryostimulation).Joint Bone Spine. 2007; 74: 617-621
- The influence of cold and compression on lymph flow at the ankle.Clin J Sport Med. 1998; 8: 266-271
- Midportion achilles tendon microcirculation after intermittent combined cryotherapy and compression compared with cryotherapy alone: a randomized trial.Am J Sports Med. 2008; 36: 2128-2138
Published online: September 03, 2014
The cryotherapy device was owned by the Department of Orthopaedics of our hospital, and we used it free of charge during the study.
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.