A Prospective Comparative Study of Postoperative Pain and Functional Outcomes With and Without Cryotherapy Following Total Knee Arthroplasty

全膝关节置换术后冷疗与非冷疗对术后疼痛和功能结果的前瞻性比较研究

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Abstract

Background Total knee arthroplasty (TKA) is a major orthopedic procedure often associated with significant postoperative pain, inflammation, and reduced range of motion (ROM). Effective pain management and functional recovery remain key challenges in postoperative care. This study aims to evaluate the impact of cryotherapy on postoperative pain and range of motion (primary outcomes) and to assess functional improvement using the Knee Society Score (KSS; secondary outcome) in patients undergoing total knee arthroplasty. This prospective study was conducted in the Department of Orthopaedic Surgery, Liaquat National Hospital, Karachi, from November 26, 2020, to May 25, 2021. Materials and methods A total of 194 patients were included in the study using consecutive non-probability sampling. Patients were divided into Group A (with cryotherapy) and Group B (without cryotherapy). Clinical evaluations were performed at baseline, on the fifth postoperative day, the second week, the sixth week, and the twelfth week. Primary outcomes included the visual analogue scale (VAS) for pain and range of motion (ROM), while the secondary outcome was the KSS. Stratification and chi-square tests (p < 0.05 as significant) were applied. Results In the twelfth week, the VAS score in Group A was 0.00 ± 0.00, indicating complete resolution of pain in all patients. In contrast, Group B reported a slightly higher mean score of 0.06 ± 0.24. Although this difference was clinically relevant, it was not statistically significant (p = 0.067). ROM was 117.92 ± 13.85 in Group A versus 114.57 ± 13.54 in Group B (p = 0.041). Knee scores were 74.46 ± 11.32 in Group A and 72.54 ± 10.43 in Group B (p = 0.029), while functional scores were 76.38 ± 10.37 in Group A and 75.18 ± 10.40 in Group B (p = 0.029). Significant differences in VAS and ROM were observed at specific time points between Group A and Group B. Conclusion The study concluded that cryotherapy significantly improved pain scores, ROM, and knee scores in patients with TKA compared to those without cryotherapy.

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