Cryotherapy in joint arthroplasty rehabilitation - Effects on pain, analgesic consumption, blood loss, and range of motion

Sep 30, 2026

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Cryotherapy’s effectiveness in rehabilitation after total joint arthroplasty remains contested. A systematic review and meta-analysis searched PubMed, Web of Science, Cochrane Library, Embase, and CIHAHL plus grey literature for randomized controlled trials. Twenty-one studies (1462 patients; 1177 TKA and 285 THA) were analyzed with RevMan 5.3, RoB 2.0, and GRADEpro. Cryotherapy after TKA reduced postoperative pain at day 2 and lowered analgesic use and postoperative blood loss markers, but did not improve range of motion. In THA, pain at days 1–2 improved without significant analgesic or blood loss changes; adverse events were not increased.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages21

Reading Time53 min

AccessFree to download

Introduction

Methods

Results

Overall findings

Subgroup findings (TKA vs THA)

Conclusion

® Systematic Review and Meta-Analysis Cryotherapy in joint arthroplasty rehabilitation Effects on pain, analgesic consumption, blood loss, and range of motion Yu Xie, MSa , Lijun Wang, MSb , Shizheng Du, MDc , Weiyu Pan, MBBSa ,* , Junjuan Zhang, MBBSa , Xin Li, MSa | Abstract
Background: Effectiveness of cryotherapy in the rehabilitation of joint arthroplasty remains controversial. Our systematic review was to evaluate application of cryotherapy following total joint arthroplasty on outcome measures related to rehabilitation exercise. Methods: PubMed, Web of Science, Cochrane Library, Embase, and CIHAHL, Grey literature, and other relevant databases for randomized controlled trials were searched. A meta-analysis was performed using Revman5 .3, and we used Cochrane risk-ofbias 2.0 (RoB2 .0) tool to evaluated the quality of included literature. We also use GRADEprofiler 3.6 software for evidence quality assessment.
Results: A systematic review of 21 studies, with a pooled analysis of 1462 patients (1177 total knee arthroplasty [TKA] and 285 total hip arthroplasty [THA]), was conducted. All assessed studies were deemed eligible for inclusion. Compared to noncryotherapy group, meta-analysis revealed that cryotherapy following TKA significantly alleviated postoperative pain on the 2nd day and reduced analgesic consumption (P< .05) . Additionally, cryotherapy was associated with a mitigation of hemoglobin changes, a reduction in blood loss infiltrating subcutaneous soft tissue, and a decrease in drainage tube output (P< .05), collectively contributing to a reduction in postoperative blood loss (P< .05) . In the subgroup analysis focusing on THA, cryotherapy was found to significantly reduce pain perception on postoperative day 1 and day 2 (P< .05) . However, no significant effects were observed on analgesic consumption or blood loss reduction (P> .05) . Notably, cryotherapy did not enhance range of motion as initially hypothesized. Subgroup analyses revealed that cryotherapy did not improve range of motion at 1 week post-TKA, on day 1 postTHA, or on day 2 post-THA (P> .05) . Furthermore, cryotherapy did not increase the risk of adverse events (P> .05) . Additionally, cryotherapy showed no significant impact on enhancing patient satisfaction with rehabilitation, reducing joint swelling, decreasing transfusion rates, or shortening hospital stays (P> .05) . The GRADE assessment determined that the quality of evidence for these outcomes ranged from very low to moderate.
Conclusion: Cryotherapy has the potential to aid in joint rehabilitation following total joint arthroplasty. However, it is essential to consider the specific type of joint replacement surgery the patient has undergone, as the rehabilitative effects of cryotherapy differ between TKA and THA. The variability in the quality of the studies included, along with limited sample sizes and generally low quality evidence, necessitates further validation of these findings through rigorously designed, large-scale, multicenter randomized controlled trials.
Abbreviations: CPM = continuous passive motion, MD = mean difference, POD = postoperative day, RCT = randomized controlled trial, ROM = range of motion, SMD = standardized mean difference, THA = total hip arthroplasty, TJA = total jointarthroplasty, TKA = total knee arthroplasty. | | --- | | Keywords: cryotherapy, meta-analysis, randomized controlled trial, systematic review, total joint arthroplasty | The authors have no funding and conflicts of interest to disclose. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. Supplemental Digital Content is available for this article. a Department of Orthopedics, Henan Provincial Intelligent Nursing and Transformation Engineering Research Center, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, JB

FAQs

What rehabilitation outcomes does the review evaluate for cryotherapy after joint arthroplasty?

It evaluates rehabilitation exercise-related outcomes including postoperative pain, analgesic consumption, blood loss measures, and range of motion.

How does cryotherapy affect pain and analgesic consumption after total knee arthroplasty (TKA)?

Compared with a non-cryotherapy group, cryotherapy after TKA significantly alleviated postoperative pain on postoperative day 2 and reduced analgesic consumption.

Does cryotherapy improve range of motion after TKA or total hip arthroplasty (THA)?

No. Subgroup analyses showed no improvement in range of motion at one week post-TKA and at specified early postoperative days post-THA.

Sep 30, 2026

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