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Comparative Effectiveness Review of Cold Compression Therapy for Patients Undergoing Orthopedic Procedures to Major Joints (Other than Knee)

November 22, 2019

Health Problem: Acute postoperative pain and swelling is common following orthopedic procedures. Inadequately controlled pain negatively affects quality of life and recovery of function and may result in an increase in morbidity, recovery time, opioid use, and risk of complications or persistent postsurgical pain.

Technology Description: Cold compression (CC) therapy involves the simultaneous application of cold and compression through a device that generally consists of a cuff or wrap and a cooler with or without a pump. CC therapy is proposed to act synergistically with cold to promote vasoconstriction to relieve edema, swelling, and muscle spasms. The intended benefits of CC therapy are reduced pain and inflammation and improved recovery in the postoperative setting.

Controversy: CC therapy can be administered at home or in outpatient clinics or hospitals. Currently, there does not appear to be a well-established protocol for the administration of CC therapy, which can be either intermittent or continuous for up to several days. Nursing activities related to CC therapy include equipment setup, maintenance of ice supply to the machine, and removal and cleaning of the machine.

Key Questions:

  • Does CC therapy offer additional benefit for reducing pain and swelling and improving function compared with other therapies in patients undergoing orthopedic procedures to major joints?
  • How does CC therapy compare with other therapies with respect to safety in patients undergoing orthopedic procedures to major joints?
  • Have definitive patient selection criteria been identified for CC therapy in patients undergoing orthopedic procedures to major joints?