An observation of compressive cryotherapy on blood loss control after total knee arthroplasty / 中国实用护理杂志

ABSTRACT

Objective To evaluate the efficacy of compressive cryotherapy on blood-loss control after total knee arthroplasty (TKA). Methods Fifty patients undergoing unilateral TKA were randomized into cryotherapy group and controlled group postoperatively. Patients in the cryotherapy group were treated with Iceman model 2200 cold therapy unit on the knee for 48 hours. The drainage volume of both groups was measured dynamically for 6 hours, 8 hours, 24 hours, 48 hours after the TKA. The hemoglobin and hematocrit were continuously followed up for 24 hours, 48 hours and 72 hours. The limb circumference was measured for 24 hours and 48 hours after the TKA. Postoperative 72-hour American Knee Society Score (KSS) was calculated. Results The hemorrhage volume of cryotherapy group was (198.12±8.88), (250.00±10.89), (301.00±15.44), (358.04±11.60) ml separately for 6 hours, 8 hours, 24 hours, 48 hours after the TKA and (249.88 ± 9.21), (302.60 ± 11.61), (369.12 ± 13.20), (450.40 ± 12.71) ml in the controlled group, (t=16.518-26.836, P<0.05) there was significant difference. The hemoglobin value of cryotherapy group was (130.1 ± 16.3), (117.5 ± 14.5), (115.0 ± 12.7) g/L separately for 24 hours, 48 hours, 72 hours, after the TKA and (119.9 ± 13.8), (106.7 ± 15.7), (108.6 ± 8.6) g/L in the controlled group, there was significant difference (t=2.07, 2.37, 2.52, P<0.05). The postoperative 24h and 48h values of hemoglobin and hematocrit were greater in the cryotherapy group than that in the controlled group (t=2.09, 2.54, P<0.05). The postoperative 24h and 48h edema (shown as limb circumference increase) was lighter in the cryotherapy group (above the knee t=2.63, 3.04, P<0.05, below the knee t=6.29, 12.03, P<0.05). These results were all statistically significant (P<0.05). The 72 h KSS values showed no differences in the two groups (P>0.05). Conclusions Compressive cryotherapy after TKA is effective in reducing blood loss and edema, which is beneficial to early recovery and functional rehabilitation.