Tag: Knee

Cold Therapy and Compression for Post-Operative Knee Recovery: What the Latest Evidence Says

Posted on | by Matthew Blackwell

Effective post-operative recovery following knee surgeries represents a significant challenge for healthcare providers as well as their patients. Procedures such as total knee arthroplasty (TKA), anterior cruciate ligament (ACL) reconstruction, and arthroscopic interventions require comprehensive recovery protocols to ensure optimal outcomes. Among the various supportive modalities available, cold therapy and compression have emerged as approaches worthy of consideration within orthopedic recovery protocols. 

This article aims to summarize the current clinical evidence surrounding cold therapy and compression techniques in post-operative knee recovery and provide insights for healthcare professionals seeking to enhance patient care following these common orthopedic procedures. 

The Clinical Challenge: Pain, Swelling, and Rehabilitation 

Post-operative knee patients commonly face several challenges that can impede their recovery trajectory. Inflammation at the surgical site often leads to significant pain, which may limit mobility and delay rehabilitation milestones. Additionally, many patients develop a reliance on pain medications, particularly opioids, which carries risks of dependence and side effects. 

These complications underscore the importance of implementing effective, low-risk adjunctive therapies that can support recovery, potentially reduce medication requirements, and improve overall patient outcomes. As healthcare providers continue to refine recovery protocols, evidence-based approaches to managing these challenges become increasingly valuable. 

What the Research Shows: A Summary of Key Studies 

Studies supporting cold therapy after Total Knee Arthroplasty (TKA) 

Several studies support the application of cold therapy following total knee arthroplasty. 

In a 2015 study by Bech et al.1, it was found that although there was no additional benefit of using the DonJoy Iceman over ice bags for pain reduction, TKA patients using the device were significantly more satisfied, used the device more consistently, day and night, and were more likely to recommend this method of cooling.

In 2006, Kullenberg et al.2 demonstrated that the Aircast Cryo/Cuff achieved better pain control, ROM improvement, and shorter hospital stays amongst 86 patients undergoing TKA than with epidural analgesia, NSAIDs, and opioids. 

Holmström et al. (2005)3 found that Aircast Cryo/Cuff is a viable alternative for pain management following TKA, as it was shown to be as effective as epidural anesthesia for pain reduction, while also being well tolerated, non-invasive, and risk-free. 

In a meta-analysis of studies on cold therapy for pain in total knee replacement patients, Yildiz et al. (2024)4 found that the application of cryotherapy was important in relieving patients’ pain, reducing it by a factor of 2.9.

Studies supporting cold therapy after ACL reconstruction

There is good evidence to support the use of cold therapy following anterior cruciate ligament (ACL) reconstruction. 

In their 2022 study, Yonetani et al.5 found that film dressing enhanced the effect of the Aircast Cryo/Cuff and Ice bags with respect to pain control immediately after ACL reconstruction surgery compared with traditional gauze dressing with elastic wrap. 

Hart et al. (2014)6 demonstrated that after ACL reconstruction, patients with arthrogenic muscle inhibition AMI who received cryotherapy immediately before performing rehabilitation exercises experienced greater strength gains than those who performed cryotherapy or exercises alone. 

Raynor et al.’s 2005 study7 showed that cryotherapy reduces post-operative pain significantly and being fairly inexpensive, easy to use, and satisfactory to patients, is therefore beneficial in the post-operative management of knee surgery. 

Furthermore, Kotsifaki et al.’s 2023 study8 resulted in the publication of new Aspetar guidelines that recommended the use of cold and compression therapy, along with neuromuscular electronic stimulation (NMES) in the early rehab protocol of ACL reconstruction.

Studies supporting cold therapy after knee arthroscopy 

According to these studies, knee arthroscopy is another procedure that can benefit from post-operative cold therapy.

In 2011, Stalman et al.9 found a significant decrease of knee temperature and associated pain and inflammation marker PGE2 with post-op Knee Cryo/Cuff application.

Martin et al.’s 2001 study10 showed a significant decrease of intraarticular temperature of the knee after arthroscopy with Aircast Cryo/Cuff application.

And Song et al.’s 201611 meta-analysis found that cold and compression is more beneficial for reduction of pain and swelling at the early post-operative period for knee surgery than cold alone. 

Conclusion

The growing body of evidence surrounding cold therapy and compression for post-operative knee recovery provides healthcare professionals with valuable insights for enhancing patient care. Across multiple procedure types, research consistently demonstrates benefits in pain management and potentially decreased reliance on pharmacological interventions. 

As a low-risk, cost-effective adjunct to established recovery protocols, cold therapy merits consideration within comprehensive rehabilitation approaches. This data may offer clinicians additional perspectives to consider when evaluating their current post-operative management approaches, with cold therapy and compression representing potential options within comprehensive rehabilitation frameworks. 

By implementing evidence-based approaches to post-operative care, healthcare providers can continue to enhance recovery experiences and outcomes for knee surgery patients, supporting their journey toward restored function and improved quality of life. 

Healthcare professionals interested in Enovis’s portfolio of cold therapy products can contact their local sales representative here.

References

  1. Bech M, Moorhen J, Cho M, Lavergne MR, Stothers K, Hoens AM. Device or ice: the effect of consistent cooling using a device compared with intermittent cooling using an ice bag after total knee arthroplasty. Physiother Can. 2015 Winter;67(1):48-55. 
  2. Kullenberg B, Ylipää S, Söderlund K, Resch S. Postoperative cryotherapy after total knee arthroplasty: a prospective study of 86 patients. J Arthroplasty. 2006 Dec;21(8):1175-9. 
  3. Holmström A, Härdin BC. Cryo/Cuff compared to epidural anesthesia after knee unicompartmental arthroplasty: a prospective, randomized and controlled study of 60 patients with a 6-week follow-up. J Arthroplasty. 2005 Apr;20(3):316-21. 
  4. Yildiz T, Topcu O, Avcu C. The effect of cryotherapy on pain in patients with total knee replacement surgery: a meta-analysis. Acta Orthop Belg. 2024 Mar;90(1):123-129. 
  5. Yonetani Y, Kurokawa M, Amano H, Kusano M, Kanamoto T, Tanaka Y, Horibe S. The Wound Dressing Influenced Effectiveness of Cryotherapy After Anterior Cruciate Ligament Reconstruction: Case-Control Study Comparing Gauze Versus Film Dressing. Arthrosc Sports Med Rehabil. 2022 Mar 8;4(3):e965-e968. 
  6. Hart JM, Kuenze CM, Diduch DR, Ingersoll CD. Quadriceps muscle function after rehabilitation with cryotherapy in patients with anterior cruciate ligament reconstruction. J Athl Train. 2014 Nov-Dec;49(6):733-9. 
  7. Raynor MC, Pietrobon R, Guller U, Higgins LD. Cryotherapy after ACL reconstruction: a meta-analysis. J Knee Surg. 2005 Apr;18(2):123-9. 
  8. Kotsifaki R, Korakakis V, King E, Barbosa O, Maree D, Pantouveris M, Bjerregaard A, Luomajoki J, Wilhelmsen J, Whiteley R. Aspetar clinical practice guideline on rehabilitation after anterior cruciate ligament reconstruction. Br J Sports Med. 2023 May;57(9):500-514. 
  9. Stålman A, Berglund L, Dungnerc E, Arner P, Felländer-Tsai L. Temperature-sensitive release of prostaglandin E₂ and diminished energy requirements in synovial tissue with postoperative cryotherapy: a prospective randomized study after knee arthroscopy. J Bone Joint Surg Am. 2011 Nov 2;93(21):1961-8. 
  10. Martin SS, Spindler KP, Tarter JW, Detwiler K, Petersen HA. Cryotherapy: an effective modality for decreasing intraarticular temperature after knee arthroscopy. Am J Sports Med. 2001 May-Jun;29(3):288-91. 
  11. Song M, Sun X, Tian X, Zhang X, Shi T, Sun R, Dai W. Compressive cryotherapy versus cryotherapy alone in patients undergoing knee surgery: a meta-analysis. Springerplus. 2016 Jul 13;5(1):1074. 

How the Defiance PRO® knee brace supports your ski and snowboard season

Posted on | by Matthew Blackwell

With winter around the corner, skiers and snowboarders are gearing up for a fresh season on the slopes. These snow sports provide a unique mix of speed, agility, and excitement—but they also bring a high risk of knee injuries, especially with the sharp turns, jumps, and high-impact landings. Whether you’re tackling moguls on skis or carving down a snowboard terrain park, the Defiance® PRO knee brace from DonJoy® offers robust protection, stability, and injury prevention for snow enthusiasts of all kinds.

Why skiers and snowboarders need knee support

Knee injuries are among the most common injuries for both skiers and snowboarders1. The rapid twisting motions in skiing, coupled with the board-fixed position in snowboarding, can put intense stress on the knee joint, especially the anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Add high speeds, dynamic movement, and unpredictable falls, and it’s easy to see why additional knee protection is essential. The Defiance PRO knee brace is designed to provide that vital support and stability, whether you’re carving powder on a snowboard or navigating steep ski trails.

Key features of the Defiance® PRO for snow sports

The Defiance PRO knee brace combines clinically proven technology with a lightweight build to provide stability, prevent injury, and enhance performance without limiting your range of motion. Here’s a closer look at how this knee brace supports skiers and snowboarders alike:

1. FourcePoint® hinge technology

The brace’s FourcePoint® hinge technology is clinically proven to help protect the knee from injury2. By keeping the knee out of full and hyperextension, its dampening mechanism helps reduce the strain on the ACL that can occur during the impacts of skiing and snowboarding2.

2. Four-Points-of-Leverage™ system

The ACL is a ligament particularly vulnerable in skiing and snowboarding. The Defiance PRO’s patented Four-Points-of-Leverage™ system is clinically proven to reduce strain on the ACL by helping to prevent forward shin movement.3 For snowboarders, who face different movement patterns but similar knee stresses, this system provides the same stability against unanticipated jerks or impacts.

3. Custom fit for comfort and stability

As well as utilizing anti-migration technology, every Defiance PRO is custom-made to fit each user’s leg shape. This is crucial for skiers and snowboarders who need a stable fit without sliding or shifting. For both sports, this stability can make all the difference on sharp turns, landings, or during intense runs.

4. Lightweight carbon fiber frame

Made from carbon fiber, the Defiance PRO is engineered to withstand high impact while remaining lightweight and low-profile. Skiers and snowboarders can wear it comfortably under their snow gear without feeling weighed down, making it ideal for long sessions on the slopes. The durable frame offers protection even in rough conditions, providing peace of mind for those aiming to push their limits.

Defiance PRO knee brace

What’s new about Defiance PRO?

Skiers and snowboarders who have worn knee braces in the past may already be familiar with the name of Defiance. Building on its legacy, the new Defiance PRO retains all the features users have come to know, while introducing several enhancements.

Even lower profile

Compared to the Defiance Classic, the profile of Defiance PRO is slimmer by 5 mm, making for an even more discrete fit.

Internally mounted swiveling straps

On the new Defiance PRO, the straps are attached to the inside of the frame for a cleaner profile with less possible friction. The straps can also swivel at these connection points, helping to provide a degree of dynamic movement while retaining that all-important stability. And with their new soft-touch ends, the straps are even easier to apply and keep fastened.

More comfortable condyle pads

Defiance PRO features new condyle pads made from soft silicone for a more comfortable contact point with the knee.

New improved liners

The Defiance PRO’s new C-6 liner material is soft to the touch, moisture wicking, and anti-microbial, all of which helps keep wearers comfortable during use.

Preventing injury and supporting recovery

For skiers and snowboarders alike, injury prevention is vital to enjoying a long and active snow season. The Defiance PRO is crafted to help prevent both acute injuries (like ACL and MCL tears) and wear-and-tear injuries that can develop over time. Skiers, who face high-speed turns and quick directional changes, and snowboarders, who need support against hard impacts and rotational movements, can both benefit from the brace’s stabilizing features.

The Defiance PRO is also a helpful tool for those in recovery. If you’re returning to skiing or snowboarding after a knee injury, the brace’s targeted support can give you confidence to get back on the mountain. A re-injury rate of 5-10% for ACL injuries shows the importance of added protection4.

But don’t be fooled that this is something that only affects more mature people; secondary ACL injuries are common in adolescents too. However, at least one clinical study with young people has shown that wearing a knee brace can help prevent injury to ACL grafts following surgery.5

Make the most of your ski season with the Defiance PRO knee brace

As you gear up for ski and snowboard season, consider the added support and injury prevention that the Defiance PRO knee brace can offer. Whether you’re an experienced skier or a snowboarder hitting the terrain park, investing in a Defiance PRO can provide the security to allow you to take on the mountain without hesitation. Make this season one to remember, with knees that are fully supported for every twist, turn, and landing.

To learn more about Defiance PRO, visit our website.

References

  1. Wagner M et al. Incidence of alpine skiing and snowboarding injuries. Injury. 2023 Aug;54(8):110830. 
  2. Yu B et al. Immediate effects of a knee brace with a constraint to knee extension on knee kinematics and ground reaction forces in a stop-jump task. Am J Sports Med 2004;32(5):1136-43.
  3. Fleming BC et al. The influence of functional knee bracing on the anterior cruciate ligament strain biomechanics in weightbearing and nonweightbearing knees. Am J Sports Med 2000;28(6):815-24.
  4. Arendt EA et al. Anterior cruciate ligament injury patterns among collegiate men and women. Journal of Athletic Training. 1999;34(2):86-92.
  5. Perrone GS et al. Risk of Secondary ACL Injury in Adolescents Prescribed Functional Bracing After ACL Reconstruction. Orthop J Sports Med. 2019;7(11):2325967119879880.