Cryotherapy after total knee replacement: a survey of current practice

Area of Science:

• Orthopaedics
• Rehabilitation Medicine
• Therapeutic Modalities

Background:

• Cryotherapy is frequently employed in physiotherapy post-total knee replacement (TKR).
• Existing evidence on cryotherapy's effectiveness after TKR is conflicting.
• There is a lack of established clinical guidelines for cryotherapy use in TKR patients.

Purpose of the Study:

• To investigate current cryotherapy practices among physiotherapists in the United Kingdom (UK) following TKR.
• To identify common methods, timings, and perceived indications for cryotherapy application.
• To explore reasons for non-application of cryotherapy post-TKR.

Main Methods:

• A postal survey was distributed to 453 senior inpatient orthopaedic physiotherapists across the UK.
• The survey included both open and closed questions to gather detailed practice information.
• Response rate was 67% (304/453), with 58% of respondents treating TKR patients in the acute phase.

Main Results:

• Only 33% of physiotherapists routinely applied cryotherapy after TKR.
• The Cryocuff device (59%) and crushed ice (30%) were the primary methods used.
• Treatments were typically applied 24-48 hours post-surgery, for 20 minutes, twice daily.
• Lack of proven efficacy was the main reason for not using cryotherapy; swelling was the most common indicator.
• Uncertainty existed regarding the management of Cryocuff devices.

Conclusions:

• Significant inconsistency exists in cryotherapy application, treatment indicators, and device management post-TKR.
• The findings highlight a need for evidence-based guidelines and further research to standardize cryotherapy protocols.
• Variations in practice were noted between public and private healthcare sectors.