Skip to main content

Advertisement

SpringerLink
Log in

Temperature-controlled continuous cold flow device versus traditional icing regimen following anterior cruciate ligament reconstruction: a prospective randomized comparative trial

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Anterior cruciate ligament (ACL) reconstruction requires an intensive rehabilitation program to be completely successful. Cryotherapy has been described to be helpful in reducing post-operative pain and edema. Aim of this prospective randomized study is to compare two homogeneous groups of patients, one receiving traditional icing regimen and the other a temperature-controlled continuous cold flow device, in post-operative setting after ACL reconstruction.

Materials and methods

Forty-seven patients treated for ACL reconstruction using “over the top” technique were enrolled for this study. All patients received the same elastocompressive bandage. Regarding the coolant device, 23 patients were randomized to temperature-controlled continuous cold flow device (Hilotherm® group) and 24 patients were randomized to receive ice bag (control group). The two groups were homogenous for pre-operative (age, sex, and time “lesion to surgery”) and intra-operative parameters (duration of the procedure, meniscectomy, and chondral damage). NRS (numeric rating scale), blood loss, knee volume increase at three established sites, ROM, and pain killers consumption were assessed. The subjective evaluation of the device including practicality and usefulness of the device was investigated.

Results

Hilotherm group resulted in lower pain perception (NRS), blood loss, knee volume increase at the patellar apex and 10 cm proximal to the superior patellar pole, and higher range of motion (p < 0.05) in the first post-operative day. No difference in pain killers consumption was noted. Hilotherm device was considered “comfortable” and “useful” by the majority of patients.

Conclusions

Hilotherm group showed significant better results in first post-operative day. Further studies with higher number of patients and longer follow-up are required to assess the beneficial effects on rehabilitation and the cost-effectiveness of the routinely use of this device.

Level of evidence: II.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Gianotti SM, Marshall SW, Hume PA, Bunt L (2009) Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study. J Sci Med Sport 12(6):622–627. doi:10.1016/j.jsams.2008.07.005

    Article  PubMed  Google Scholar 

  2. Siegel L, Vandenakker-Albanese C, Siegel D (2012) Anterior cruciate ligament injuries: anatomy, physiology, biomechanics, and management. Clin J Sport Med 22(4):349–355. doi:10.1097/JSM.0b013e3182580cd0

    Article  PubMed  Google Scholar 

  3. Murawski CD, van Eck CF, Irrgang JJ, Tashman S, Fu FH (2014) Operative treatment of primary anterior cruciate ligament rupture in adults. J Bone Joint Surg Am 96(8):685–694. doi:10.2106/JBJS.M.00196

    Article  PubMed  Google Scholar 

  4. van Grinsven S, van Cingel RE, Holla CJ, van Loon CJ (2010) Evidence-based rehabilitation following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 18(8):1128–1144. doi:10.1007/s00167-009-1027-2

    Article  PubMed  Google Scholar 

  5. Glenn RE Jr, Spindler KP, Warren TA, McCarty EC, Secic M (2004) Cryotherapy decreases intraarticular temperature after ACL reconstruction. Clin Orthop Relat Res 421:268–272

    Article  PubMed  Google Scholar 

  6. Lessard LA, Scudds RA, Amendola A, Vaz MD (1997) The efficacy of cryotherapy following arthroscopic knee surgery. J Orthop Sports Phys Ther 26(1):14–22

    Article  CAS  PubMed  Google Scholar 

  7. Martin SS, Spindler KP, Tarter JW, Detwiler KB (2002) Does cryotherapy affect intraarticular temperature after knee arthroscopy? Clin Orthop Relat Res 400:184–189

    Article  PubMed  Google Scholar 

  8. Woolf SK, Barfield WR, Merrill KD, McBryde AM Jr (2008) Comparison of a continuous temperature-controlled cryotherapy device to a simple icing regimen following outpatient knee arthroscopy. J Knee Surg. 21(1):15–19

    Article  PubMed  Google Scholar 

  9. Stålman A, Berglund L, Dungnerc E, Arner P, Felländer-Tsai L (2011) Temperature-sensitive release of prostaglandin E2 and diminished energy requirements in synovial tissue with postoperative cryotherapy: a prospective randomized study after knee arthroscopy. J Bone Joint Surg Am 93(21):1961–1968. doi:10.2106/JBJS.J.01790

    Article  PubMed  Google Scholar 

  10. Wilke B, Weiner RD (2003) Postoperative cryotherapy: risks versus benefits of continuous-flow cryotherapy units. Clin Podiatr Med Surg 20(2):307–322

    Article  PubMed  Google Scholar 

  11. Martimbianco AL, Gomes da Silva BN, de Carvalho AP, Silva V, Torloni MR, Peccin MS (2014) Effectiveness and safety of cryotherapy after arthroscopic anterior cruciate ligament reconstruction. A systematic review of the literature. Phys Ther Sport 15(4):261–268. doi:10.1016/j.ptsp.2014.02.008

    Article  PubMed  Google Scholar 

  12. Raynor MC, Pietrobon R, Guller U, Higgins LD (2005) Cryotherapy after ACL reconstruction: a meta-analysis. J Knee Surg 18(2):123–129

    Article  PubMed  Google Scholar 

  13. Daniel DM, Stone ML, Arendt DL (1994) The effect of cold therapy on pain, swelling, and range of motion after anterior cruciate ligament reconstructive surgery. Arthroscopy 10(5):530–533

    Article  CAS  PubMed  Google Scholar 

  14. Barber FA, McGuire DA, Click S (1998) Continuous-flow cold therapy for outpatient anterior cruciate ligament reconstruction. Arthroscopy 14(2):130–135

    Article  CAS  PubMed  Google Scholar 

  15. Moro A, Gasparini G, Marianetti TM, Boniello R, Cervelli D, Di Nardo F, Rinaldo F, Alimonti V, Pelo S (2011) Hilotherm efficacy in controlling postoperative facial edema in patients treated for maxillomandibular malformations. J Craniofac Surg. 22(6):2114–2117. doi:10.1097/SCS.0b013e31822e5e06

    Article  PubMed  Google Scholar 

  16. Modabber A, Rana M, Ghassemi A, Gerressen M, Gellrich NC, Hölzle F, Rana M (2013) Three-dimensional evaluation of postoperative swelling in treatment of zygomatic bone fractures using two different cooling therapy methods: a randomized, observer-blind, prospective study. Trials. 14:238. doi:10.1186/1745-6215-14-238

    Article  PubMed Central  PubMed  Google Scholar 

  17. Rana M, Gellrich NC, von See C, Weiskopf C, Gerressen M, Ghassemi A, Modabber A (2013) 3D evaluation of postoperative swelling in treatment of bilateral mandibular fractures using 2 different cooling therapy methods: a randomized observer blind prospective study. J Craniomaxillofac Surg 41(1):e17–e23. doi:10.1016/j.jcms.2012.04.002

    Article  PubMed  Google Scholar 

  18. Schröder D, Pässler HH (1994) Combination of cold and compression after knee surgery. A prospective randomized study. Knee Surg Sports Traumatol Arthrosc 2(3):158–165

    Article  PubMed  Google Scholar 

  19. Waterman B, Walker JJ, Swaims C, Shortt M, Todd MS, Machen SM, Owens BD (2012) The efficacy of combined cryotherapy and compression compared with cryotherapy alone following anterior cruciate ligament reconstruction. J Knee Surg 25(2):155–160

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. I Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy

    Alberto Ruffilli, Francesco Castagnini & Daniela Di Nicolantonio

  2. Orthopaedics and Traumatology, I Clinic, Rizzoli Orthopaedic Institute, University of Bologna, Bologna, Italy

    Roberto Buda, Sandro Giannini & Cesare Faldini

  3. Department of General Surgery and Orthopaedics, Villa Erbosa, Bologna, Italy

    Giulia Evangelisti

  4. Orthopaedics and Traumatology, Rizzoli-Sicilia Department, Bagheria, Italy

    Cesare Faldini

Authors
  1. Alberto Ruffilli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roberto Buda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Francesco Castagnini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniela Di Nicolantonio
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Giulia Evangelisti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sandro Giannini
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Cesare Faldini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francesco Castagnini.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ruffilli, A., Buda, R., Castagnini, F. et al. Temperature-controlled continuous cold flow device versus traditional icing regimen following anterior cruciate ligament reconstruction: a prospective randomized comparative trial. Arch Orthop Trauma Surg 135, 1405–1410 (2015). https://doi.org/10.1007/s00402-015-2273-z

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-015-2273-z

Keywords

Search

Navigation