Experience in the use of cryotherapy in patients after total replacement

BACKGROUND: All over the world, total joint replacement is one of the most popular surgical technologies due to the widespread prevalence of joint diseases, as well as injuries. There is no doubt that rehabilitation is a necessary component of the complex treatment of the patient and plays an important role in the postoperative period. Physiotherapeutic methods of treatment occupy a special place in rehabilitation programs. Cryotherapy has been used for many years in the pathology of the musculoskeletal system and has proven its clinical effectiveness due to analgesic, anti-inflammatory and decongestant effects, which gives grounds for its use after surgical interventions.

AIM: Based on the above, the purpose of this study was to study the effectiveness and rationale for the use of cryotherapy in combination with therapeutic gymnastics procedures in patients after total knee replacement for the third the rehabilitation stage.

MATERIALS AND METHODS: The study included 60 patients after total knee replacement at the age of 57 to 79 years. All patients were admitted for outpatient treatment 3 months after surgery and were divided into 2 groups. The first group consisted of 30 patients who had therapeutic gymnastics classes with a physical therapy instructor (physical therapy), for a course of 10 daily procedures. The second group consisted of 30 patients who underwent a comprehensive rehabilitation program, including therapeutic gymnastics and air cryotherapy, for a course of 10 daily procedures.

RESULTS: In all patients, before the start of the rehabilitation course, the intensity of the pain syndrome according to VAS averaged 4.5±0.6 points; according to the 10-meter walking test, a decrease in the level of mobility was detected, in most patients, the sum of the points on the two parts of the KSS scale averaged 62.8±4.5; according to the results of laser Doppler flowmetry, 44% of the subjects revealed spastic, and in 56% ― spastic-stagnant type of microcirculation. After a course of complex rehabilitation treatment, a significantly more significant reduction in pain syndrome (according to VAS) and microcirculatory disorders (according to laser Doppler flowmetry), improvement in the function of the operated joint (according to the KSS scale) was revealed, compared with the use of physical therapy as a monomethod, which contributed to an increase in the level of mobility of patients.

CONCLUSION: The combined use of air cryotherapy and therapeutic gymnastics in patients after total knee replacement contributes to the formation of pronounced analgesic, anti-inflammatory and vasocorrecting effects, which allowed to increase the effectiveness of treatment at the 3rd stage of rehabilitation treatment.