Crack Dol^® vs. cryotherapy in postoperative pain treatment after patellar fracture fixation

Postoperative pain following patellar fracture surgery may delay rehabilitation and impair functional recovery. While cryotherapy is commonly used, concerns exist regarding its effects on local blood flow. Alternative topical cooling formulations may offer analgesic benefits without prolonged vasoconstriction. In this study, we compared postoperative pain, functional recovery, quality of life, and rescue analgesic consumption among patients receiving traditional ice therapy, ice spray, or Crack Dol® Foam Spray following surgical fixation of patellar fractures. Ninety patients undergoing surgical fixation for patellar fracture were prospectively enrolled in this non-randomized comparative cohort study and allocated into three groups (n=30 each) based on patient preference and clinical contraindications: ice therapy, ice spray, and Crack Dol® Foam Spray. Pain intensity (Visual Analogue Scale, VAS), health-related quality of life (SF-12), knee function (KOOS), and rescue analgesic consumption were assessed during postoperative follow-up. Patients in the Crack Dol® Foam Spray group had significantly lower VAS scores at 7, 30, and 90 days compared with the ice and ice spray groups (p=0.012, p=0.006, and p=0.004, respectively). At 90 days, SF-12 Physical and Mental Component Scores were significantly higher in the Crack Dol® group (p=0.009 and p=0.014, respectively). KOOS total scores were also significantly higher at 30 and 90 days (p=0.018 and p=0.007, respectively). Rescue analgesic consumption was significantly lower in the Crack Dol® group (p=0.011). In this prospective, non-randomized comparative cohort study, the use of Crack Dol® Foam Spray was associated with lower postoperative pain scores, lower rescue analgesic consumption, and better patient-reported functional and quality-of-life outcomes compared with traditional ice therapy and ice spray. Given the non-randomized treatment allocation, these findings should be interpreted as associations rather than evidence of a causal treatment effect. Further randomized controlled trials are needed to confirm these preliminary findings.