Cryotherapy Following Total Knee Replacement

Added on - 13 Sep 2019

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Effect of cryotherapy, emotional support and exercises on mobility after totalknee replacementTotal knee replacement (TKR) is one of the most common surgical procedures to rectify thepain associated with joints, and has been predicted to be increase (Kurtz et al., 2007) infuture. Following TKR, patients frequently experience intense levels of pain, stress, andanxiety that may reduce their self-efficacy and thus affect their postoperative recovery. Theintent of TKR is to provide relief from chronic pain and improve function. However, mostpatients experience chronic post-surgical pain. To control pain perception, centrally actingpain suppressants such as opioid based drugs can be given by epidural route and is popularlyknown as patient controlled analgesia (PCA) (ASATF, 2012). The drugs act centrally bybinding to receptors, named mu, kappa, sigma, delta, and epsilon. Continuous infusion ofmorphine as a part of PCA can cause respiratory depression therefore the patients have to becarefully monitored. To avoid such adverse events it would be desired to use alternativetherapies such as cryotherpy. Therefore, it was aimed to describe the alternative modes oftherapy in TKR to improve the mobility of patients with TKR and reduce the pain perception.Cryotherapy (use of cold utilities, ice bags or cooled water) promotes vasoconstriction, andreduces the tissue trauma after surgery thereby it minimizes the extent of tissue trauma afterknee surgery (Adie et al., 2009). However researchers opined that the use of ice alone showswelling due cold induced ischemic damage to blood vessels and recommending usingsimultaneously the application of cold and compression (Kullenberg et al., 2006).Cryotherapy offers pain suppression similar to that of PCA (Holmstrom, & Hardin, 2005), sothe administration of morphine can be avoided. From the evidences, it can be understood thatthe cold alone not suffices to improve the range of motion. Both cold and compressionappears to be showing an improvement of range of motion (Markert, 2011). Despite theoverwhelming success of TKR, functional improvement after surgery varies widely. Poorfunctional results have been associated with poor emotional health, such as anxiety,depression, poor coping skills, and poor social support (Ayers et al., 2005). The patients whoare at risk of having less functional improvement after orthopaedic surgery can be identifiedpreoperatively. Accordingly, support would be extended to increase the level of confidenceso that the patients with TKR are recovered easily. The heath care team of clinicians, physicaltherapists, behavioral psychologists, and other support professionals involves in providing the1
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