Cold versus cold compression therapy after shoulder arthroscopy: a prospective randomized clinical trial.

Abstract

Purpose of the present study was to investigate the acute effects of a cold compression bandage on pain, swelling and skin-surface temperature after the first 24h after arthroscopic surgery of the shoulder in a stationary setting and to compare it with cold therapy using only a cold pack. It was hypothesized that using the bandage is more effective in reducing pain and swelling after 24h compared with using only a cold pack. Fifty-two patients (53±12.2years) were randomly assigned to two groups after arthroscopic surgery. The first group wore a cold compression bandage, and the second group a conventional frozen cold pack. Pain, swelling and skin-surface temperature were measured 2, 8 and 24h after surgery. Differences within and between groups were analysed. Both groups showed a significant reduction of the circumference of the arm 15 and 20cm proximal of the lateral epicondyle 24h after surgery (cold compression: p=0.003; p<0.001; cold: p<0.001). Pain at rest was significantly reduced with cold compression bandage 24h after surgery (p=0.001). Skin temperature increased in both groups 24h after surgery (bandage: p<0.001; cold pack: p=0.002). After 24h, pain during activity was significantly decreased in the group wearing the bandage compared with the group using the cold pack (p=0.026). Based on the results of this study, no recommendation can be made with respect to the question whether cold compression therapy or cold therapy should be preferred immediately after arthroscopic surgery of the shoulder. Clinicians should question the need of expensive cold compression bandages in the short-term post-operative treatment after arthroscopic surgery of the shoulder. II.