Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 23, Issue 11, pp 3354–3361 | Cite as

Cryotherapy on postoperative rehabilitation of joint arthroplasty

  • Sheng-Hui Ni
  • Wen-Tong Jiang
  • Lei GuoEmail author
  • Yu-Heng Jin
  • Tian-Long Jiang
  • Yuyan Zhao
  • Jie Zhao



The effectiveness of cryotherapy on joint arthroplasty recovery remains controversial. This systematic review was conducted to assess the effectiveness of cryotherapy in patients after joint arthroplasty.


Comprehensive literature searches of several databases including Cochrane Library (2013), MEDLINE (1950–2013), and Embase (1980–2013) were performed. We sought randomised controlled trials that compared the experimental group received any form of cryotherapy with any control group after joint arthroplasty. The main outcomes were postoperative blood loss, adverse events, and pain. Analyses were performed with Revman 5.0. Results were shown as mean differences (MD) and standard deviations or as risk difference and 95 % confidence intervals (CIs).


Ten trials comprised 660 total knee arthroplastys and three trials comprised 122 total hip arthroplastys (THAs) met the inclusion criteria. Blood loss was significantly decreased by cryotherapy (MD = −109.68; 95 % CI −210.92 to −8.44; P = 0.03). Cryotherapy did not increase the risk of adverse effect (n.s.). Cryotherapy decreased pain at the second day of postoperative (MD = −1.32; 95 % CI −2.37 to −0.27; P = 0.0003), but did not decreased pain at the first and third day of postoperative (n.s.).


Cryotherapy appears effective in these selected patients after joint arthroplasty. The benefits of cryotherapy on blood loss after joint arthroplasty were obvious. However, the subgroup analysis indicated that cryotherapy did not decreased blood loss after THA. Cryotherapy did not increase the risk of adverse effect. Cryotherapy decreased pain at the second day of postoperative, but did not decreased pain at the first and third day of postoperative.

Level of evidence



Total knee arthroplasty (TKA) Total hip arthroplasty (THA) Cryotherapy 



We are thankful to China Medical University—affiliated Hospital Laboratory Centre for kindly providing the necessary equipments for this study. This work was supported by the National Natural Science Foundation of China (Grant Numbers 30872724, 81071460, and 81271996), the Natural Science Foundation of Liaoning Province (Grant Number 201202292).

Conflict of interests

The authors declared no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Sheng-Hui Ni
    • 1
  • Wen-Tong Jiang
    • 2
  • Lei Guo
    • 1
    Email author
  • Yu-Heng Jin
    • 1
  • Tian-Long Jiang
    • 1
  • Yuyan Zhao
    • 1
  • Jie Zhao
    • 1
  1. 1.Department of Orthopedic Surgery, First Affiliated HospitalChina Medical UniversityShenyangPeople’s Republic of China
  2. 2.Department of Medical OncologyShengjing Hospital of China Medical UniversityShenyangPeople’s Republic of China

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