Continuous cold therapy in total knee arthroplasty.

This article describes a retrospective study that assessed 52 consecutive patients who underwent total knee arthroplasty (TKA) between January 1, 1992 and September 15, 1992. Thirty-three patients underwent TKA and received cold therapy pads placed over a thin dressing in the operating room. Nineteen patients underwent TKA using an identical operative and postoperative procedure, but did not receive continuous cold therapy. Continuous cold therapy consisted of two sterile plastic pads connnected by rubber hoses containing cool water from an electric main unit that maintained a constant temperature of 42 degrees F for the immediate postoperative period. Cold therapy pads were used an average of 3 days and removed with the first dressing change. Patients who had continuous cold therapy averaged a 200 cc decrease in postoperative blood loss. There was no significant difference in the amount of narcotic use, transfusion requirements, or hospital stay between the two groups. Postoperative swelling and range of motion were not consistently recorded. Twenty-eight other variables also examined not significant. Based on these results, we cannot recommend continuous cold therapy or justify the extra expense for all patients who undergo TKA.