# A reassessment of existing systematic reviews evaluating the effectiveness of cryotherapy in patients following total knee arthroplasty

## TL;DR

This study evaluates the quality of existing research on cryotherapy's effectiveness for pain and swelling after knee replacement surgery.

## Contribution

The study identifies significant methodological flaws in most systematic reviews on cryotherapy post-TKA and highlights the need for higher-quality research.

## Key findings

- Only two of five systematic reviews on cryotherapy after TKA showed high methodological quality.
- Most outcome indicators related to cryotherapy had low or exceedingly low-quality evidence.
- Cryotherapy may help with pain relief and joint swelling but needs better validation.

## Abstract

This study reassessed systematic reviews on cryotherapy efficacy following total knee arthroplasty (TKA).

Ten databases were searched from January 1, 2018 to September 15, 2023 for relevant systematic reviews. Two researchers independently screened articles and extracted data.

Five systematic reviews were included. Two of the studies were found to exhibit high methodological quality, while the remaining three demonstrated exceedingly low methodological quality. The deficiencies in quality were attributed to several factors, including the lack of a predefined research protocol, absence of exclusion criteria, unclarified funding sources for the included studies, and potential for publication bias. Of the 18 outcome indicators, Swelling was intermediate-quality evidence , Hemoglobin, Pain score within 24 hours after surgery, Pain score within 48 hours after surgery, Pain score within 72 hours after surgery, Blood loss volume, Pain score on the next day of surgery and Range of Motion (ROM) were low-quality evidence, and other outcome indicators were exceedingly low-quality evidence.

Cryotherapy appears to offer benefits such as pain relief, reduction in joint swelling, and improved joint mobility during the initial post-operative phase following TKA. However, further high-quality studies are required to validate the efficacy and safety of cryotherapy for patients undergoing TKA, given the identified limitations in the quality of the available outcome indicators.