Knee replacement:
what cryocompression changes

Two trials, and what they say precisely

Medium term functional outcomes after TKA are excellent. The early phase remains uncomfortable, and it sets the pace of rehabilitation.

Haemarthrosis and capsular distension inhibit the quadriceps, peri-articular oedema limits passive mobility, and nociceptive pain reduces active participation in sessions. The three feed one another.

Two trials measured what active cryocompression changes here.

The 2024 trial: speed, not the ceiling

Forty patients in a rehabilitation centre, the Game Ready® against ice packs with elastic bandaging, 21 days, with an identical rehabilitation protocol in both groups¹.

On the six minute walk test at day 21, 439 metres against 340¹.

At day 21, final flexion was comparable between groups, 82.5 against 80 degrees, with no significant difference, and knee circumference did not differ significantly either¹. What cryocompression changes is therefore not the range reached at the end of three weeks, it is the time taken to get there.

And those timings are what govern autonomy. Around 90 degrees, the patient sits down and rises from a chair, and climbs stairs. Beyond 105 to 110, they come down stairs, get up from a low seat, and get into a car. Each of those thresholds corresponds to a movement the patient makes again or cannot yet make, and crossing them several days earlier sustains the momentum of rehabilitation.

The 2012 multicentre trial: opioid sparing

Two hundred and eighty patients, eleven centres, a cryopneumatic device against ice with static compression².

Over two weeks, consumption was 509 mg of morphine equivalent against 680², a quarter less. Patient satisfaction with the cooling regimen was significantly higher².

At two and six weeks, pain, swelling and range of motion did not differ significantly between the groups². The documented benefit is on the quantity of analgesia consumed, not on the pain reported.

What it changes in prescription

Cryocompression extends multimodal analgesia and enhanced recovery protocols where they stop, which is at home, where most of the first weeks take place.

In practice: sessions of 20 to 30 minutes, several times a day through the inflammatory phase, then framing physiotherapy sessions. Before, to mobilise a joint that hurts less. After, to limit the inflammatory response to the effort.

Less morphine also means a more alert patient, more available for rehabilitation, with less nausea, less drowsiness and less postoperative confusion.

Kolde at the patient's home

Kolde rents the Game Ready® GRPro 2.1 directly to the patient's home, with delivery, set-up and a hands-on walkthrough by a member of the team, and support reachable at any hour. On the six minute walk test at day 21, the gap between the two groups was around a hundred metres¹. That is what three weeks of the device at home represents.