While
cryotherapy has been shown to decrease
postoperative pain after anterior cruciate ligament (ACL) reconstruction, less is known of the effects of combined
cryotherapy and compression. The goal of this study was to compare subjective and objective patient outcomes following ACL reconstruction with combined compression and
cryotherapy compared with traditional
ice therapy alone. Patients undergoing ACL reconstruction were randomized to
cryotherapy/compression device (group 1) or a standardized
ice pack (group 2). Both groups were instructed to use the
ice or
cryotherapy/compression device three times per day and return to the clinic at 1, 2, and 6 weeks postoperatively. Patient-derived outcome measurements used in this study consisted of the visual analog scale (VAS), the Lysholm knee score, Short Form-36 (SF-36), and single assessment numerical evaluation (SANE). Circumferential measurements of the knee at three locations (1 cm proximal to patella, mid-patella, and 1 cm distal to patella) were also obtained as a measure of postoperative
edema.
Narcotic medication use was recorded by questionnaire. The primary outcome measure (VAS) was significantly different among groups in the preoperative measurement, despite similarities in group demographics. Baseline VAS for group 1 was 54.9 compared with group 2 at 35.6 (p = 0.01). By 6 weeks, this had lowered to 28.1 and 40.3, respectively, resulting in a significant 27-point decrease in mean VAS for group 1 (p < 0.0001). However, the small increase in VAS for group 2 was not significant (p = 0.34). No significant differences were noted for the Lysholm, SF-36, or SANE scores either between groups or time points. Furthermore, no significant differences were noted for any of the circumferential measurements either between groups or time points. Of all patients, 83% of group 1 discontinued
narcotic use by 6 weeks, compared with only 28% of group 2 (p = 0.0008). The use of combined
cryotherapy and compression in the postoperative period after ACL reconstruction results in improved, short-term
pain relief and a greater likelihood of independence from
narcotic use compared with
cryotherapy alone.