Xavier Guillot1, Nicolas Tordi2, Clément Prati3, Frank Verhoeven4, Lionel Pazart5, Daniel Wendling6. 1. Rheumatology Department, University Hospital of Besançon, Boulevard Fleming, 25030 Besançon Cedex, France; FDE EA4267, FHU INCREASE, Bourgogne Franche-Comté University, 25000 Besançon, France. Electronic address: xguillot@chu-besancon.fr. 2. FDE EA4267, FHU INCREASE, Bourgogne Franche-Comté University, 25000 Besançon, France. 3. Rheumatology Department, University Hospital of Besançon, Boulevard Fleming, 25030 Besançon Cedex, France; FDE EA4267, FHU INCREASE, Bourgogne Franche-Comté University, 25000 Besançon, France. 4. Rheumatology Department, University Hospital of Besançon, Boulevard Fleming, 25030 Besançon Cedex, France. 5. CIC IT, INSERM Center CIT 808, University Hospital of Besançon, Boulevard Fleming, 25030 Besançon Cedex, France. 6. Rheumatology Department, University Hospital of Besançon, Boulevard Fleming, 25030 Besançon Cedex, France; EA 4266, Bourgogne Franche-Comté University, 25000 Besançon, France.
Abstract
OBJECTIVE: To measure and compare the effects of 2 local cryotherapy techniques on synovial power Doppler activity (primary outcome) and pain in non-septic knee arthritis without any concurrent treatment. METHODS:30 patients were randomized (ice: 30min, n=15 or cold CO2: 2min, n=15 both applied twice at 8h interval). Contralateral non-treated arthritic knees were used as paired controls (n=11 and n=10 respectively). The PDUS semi-quantitative score (0-3) and pain visual analogic scale were evaluated before/after each cold application, 2min, 2h, 24h after the first application. PDUS scores were checked in double-blind by 2 ultrasonographists. RESULTS: The inter-class effect size of local cryotherapy on the power Doppler score remained significant the day after treatment in local cryotherapy-treated compared to contralateral non-treated knees (Global difference: -1 [95% confidence interval: -1.23; -0.77]; ice: -0.73 [-1.06; -0.4]; CO2: -0.7 [-1.18; -0.22]). Both techniques significantly and to the same extent reduced the power Doppler score and pain visual analogic scale at all evaluation times and globally throughout the 24 hour-study period. No dropout nor adverse event was reported. In multivariate analysis, the Power Doppler score decrease was associated with pain decrease, while pain decrease was associated with the female sex and ice technique. CONCLUSION:Local ice and cold CO2 applied twice equally reduced synovial Power Doppler activity and pain over 24h in knee arthritis. These effects remained significant the day after treatment. ClinicalTrials.gov identifier: NCT02573298.
RCT Entities:
OBJECTIVE: To measure and compare the effects of 2 local cryotherapy techniques on synovial power Doppler activity (primary outcome) and pain in non-septic knee arthritis without any concurrent treatment. METHODS: 30 patients were randomized (ice: 30min, n=15 or cold CO2: 2min, n=15 both applied twice at 8h interval). Contralateral non-treated arthritic knees were used as paired controls (n=11 and n=10 respectively). The PDUS semi-quantitative score (0-3) and pain visual analogic scale were evaluated before/after each cold application, 2min, 2h, 24h after the first application. PDUS scores were checked in double-blind by 2 ultrasonographists. RESULTS: The inter-class effect size of local cryotherapy on the power Doppler score remained significant the day after treatment in local cryotherapy-treated compared to contralateral non-treated knees (Global difference: -1 [95% confidence interval: -1.23; -0.77]; ice: -0.73 [-1.06; -0.4]; CO2: -0.7 [-1.18; -0.22]). Both techniques significantly and to the same extent reduced the power Doppler score and pain visual analogic scale at all evaluation times and globally throughout the 24 hour-study period. No dropout nor adverse event was reported. In multivariate analysis, the Power Doppler score decrease was associated with pain decrease, while pain decrease was associated with the female sex and ice technique. CONCLUSION: Local ice and cold CO2 applied twice equally reduced synovial Power Doppler activity and pain over 24h in knee arthritis. These effects remained significant the day after treatment. ClinicalTrials.gov identifier: NCT02573298.
Authors: H Martin; C Demougeot; C Peyronnel; P Totoson; V Petitcolin; F Bonnefoy; X Guillot; P Saas; F Verhoeven Journal: Arthritis Res Ther Date: 2022-04-29 Impact factor: 5.606