The role of a cryocompression device following total knee arthroplasty to assist in recovery: a randomised controlled trial

Abstract

Purpose: The study sought to investigate the effectiveness of a cryocompression Game Ready™ (GR) versus usual care protocol (UC) on early post-operative recovery following total knee arthroplasty.

Methods: This study prospectively randomised 72 total knee arthroplasties to a 2-week (from day 0) intervention of GR treatment (n = 36, 63.9% females) or UC of ice with static compression (n = 36, 45.7% females). Knee flexion and extension range of motion (ROM), a visual analogue pain scale and limb circumference were documented at day 1, 2 and 14, as well as 6 weeks post-surgery. Medication usage and length of hospital stay were documented. Patient-reported outcome measures (PROMs) included the Knee Injury and Osteoarthritis Outcome Score and a Patient Satisfaction Questionnaire. Statistical analysis using linear mixed modelling and analysis of variance table with Satterthwaite's method were used along with two-tailed t-tests.

Results: There were no significant group-by-time interactions regarding any of the outcomes. The GR group had 19% lost to follow-up at 2 weeks, while the UC group had 8%. The GR group demonstrated significantly better knee extension ROM at day 1 (p = 0.048) and day 14 (p = 0.007) compared with the UC group. There were no group differences (n.s.) observed in pain, flexion ROM, limb circumference, opioid use or PROMs. Overall, higher pain levels resulted in increased opioid intake (p = 0.002), older patients used significantly less opioids (p < 0.001) and males reported significantly less pain than females (p = 0.048). No adverse effects were observed due to either protocol.

Conclusion: Despite patients gaining significantly more knee extension during the initial two-week intervention period when using GR compared to UC, this effect was likely due to chance. No further significant differences were observed between the groups during or after cession of the intervention.

Level of evidence: Level 2.

Keywords: Clinical outcomes; Cryocompression; Game Ready™; Pain; Patient satisfaction; Patient-reported outcome measures; Range of motion; Rehabilitation; Total knee arthroplasty.