Knee temperatures measured in vivo after arthroscopic ACL reconstruction followed by cryotherapy with gel-packs or computer controlled heat extraction
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To obtain in vivo data about intra- and extra-articular knee temperatures to assess the effectiveness of two cryotherapeutic methods—conventional cooling with gel-packs and computer controlled cryotherapy following anterior cruciate ligament (ACL) reconstructive surgery.
Twenty patients were arbitrarily assigned for cryotherapy after ACL reconstruction: 8 patients with frozen gel-packs and 12 patients with computer controlled cryotherapy with constant temperatures of the cooling liquid in the knee pads. The treatment was performed for 12 h. Temperatures were measured with two thermo sensors in catheters placed intraarticularly and subcutaneously, four sensors on the skin and one sensor under protective bandage, every second for 16 h after surgery.
In the first 2 h of treatment, there were no significant differences (n.s.) between the groups in temperatures in the intracondylar notch. After 4 h of cryotherapy, the temperatures were significantly lower on the skin (24.6 ± 2.8 and 31.4 ± 1.3 °C, p < 0.01) and in the subcutaneous tissue (28.6 ± 5.7 and 34.6 ± 1.4 °C, p = 0.01), and the difference between the temperature in the intracondylar notch and the subcutaneous tissue was significantly greater (4.0 ± 3.0 and 0.8 ± 0.6 °C, p = 0.01) in the computer controlled cryotherapy group compared to the gel-pack group.
The cooling effect of the arthroscopy irrigation fluid on the knee temperature is evident in the first 2 h of treatment. The energy extraction is significantly more effective and controllable by computer controlled cryotherapy than with frozen gel-packs.
Level of evidence
Prospective comparative study, Level II.
KeywordsArthroscopy Anterior cruciate ligament Cryotherapy Temperature
We thank the staff of the University Medical Centre Ljubljana, Department of Traumatology, Slovenia, for their generous support, and WAEGENER R&D NV, Belgium, for the cTreatment® device and partial funding. We also thank MSc Ivan Tomasić for his assistance in the statistical analysis. We acknowledge the remaining financial support from the state budget by the Slovenian Research Agency under the Grant P2-0095.
- 8.Grana W (1994) Cold modalities. In: DeLee JC, Drez D (eds) Orthopaedic sports medicine: principles and practice. WB Saunders, Philadelphia, pp 203–207Google Scholar
- 9.Knight KL (1985) Cryotherapy: theory, technique and physiology. Education Division, Chattanooga Corporation, ChattanoogaGoogle Scholar
- 13.McGuire DA, Hendricks SD (2006) Incidences of frostbite in arthroscopic knee surgery postoperative cryotherapy rehabilitation. Arthroscopy 22:1141e1–1141e6Google Scholar
- 18.Shelbourne KD, Rubinstein RA Jr, McCarroll JR, Weaver J (1994) Postoperative cryotherapy for the knee in ACL reconstructive surgery. Orthopedics 2:165–170Google Scholar
- 20.Waegener R&D, Belgium, http://www.waegener.com