Randomized Control Trial of Combined Cryotherapy with Compression Versus Cryotherapy Alone After Orthopaedic Surgery

Opioids are most commonly administered for the treatment of pain and are among the most prescribed drugs in the United States. Between 2003 and 2011, opioid prescriptions increased from 149 million to 238 million. In 2004, while constituting only 4.5% of the world’s population, the US consumed 99% of the global supply of hydrocodone. These trends resulted in the Centers for Disease Control and Prevention recognizing opioid abuse as an epidemic. 

Pain management after orthopaedic arthroscopic procedures is mandatory regardless of the surgical technique. Cold therapy (cryotherapy) has been widely used for many years in the treatment of postoperative pain management in orthopaedic surgery, and most studies have reported better pain scores and reduced drug consumption. Cryotherapy involves applying a cold device to the skin surrounding the injured soft tissues to reduce the intraarticular temperature. It reduces local blood flow by vasoconstriction, which in turn also reduces local inflammatory reaction, swelling, and heat. It also decreases the conduction of nerve signals, potentially reducing pain transmission. Several cryotherapy options are available: first generation cold therapy like crushed ice in a plastic bag, cold or gel packs; second-generation cold therapy with circulating ice water with or without compression, and third-generation advanced computer-assisted devices with continuous controlled cold therapy.

Our goal is to analyze the analgesic efficacy of cryotherapy after shoulder, knee, and hip arthroscopic procedures using Game Ready® which is a second-generation cryotherapy with compression system. We hypothesize this may decrease postoperative opioid usage, as well as be more cost effective when compared to first-generation cryotherapy (ice packs without compression) for medical healthcare systems.