CRYOTHERAPY AS AN ANALGESIC TECHNIQUE IN DIRECT POSTOPERATIVE MANAGEMENT OF ELECTIVE JOINT REPLACEMENT

The application of crushed ice or hydrogenated silicate, a micro-cryst alline substitute has been used as a method to treat posttraumatic and postoperative irritations of the locomotor system for a long time. Cl osed systems using pumps can be viewed as further development as they enable continous, water-free cooling of operating areas. The analgetic effect of postoperative cold therapy was evaluated in a prospective c linical trial, including 312 patients after total knee or hip arthropl asty. Conventional cold packs, consisting of microcrystalline silicate were compared to a continous applicable closed system. Continous cryo therapy resulted a depression of skin temperature to 12 degrees C, whe reas intermittend cooling only caused a mean temerature decrease of 1 degrees C. Clinically continous cold application leads to a more than 50% decrease of analgetic demands in both, systemic and regional appli cation (p < 0,001). This oberservation was found in a significant corr elation with patient's pain sensation as well as primary range of moti on. Intermittant cryotherapy was found to be ineffective in postoperat ive pain relieve in hip- an inadaequat in knee arthroplasty patients. We could not report an influence to postoperative blood loss, as dicus sed in previous reports.