{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:05:00Z","timestamp":1790255100839,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Cryotherapy modulates synovial fluid composition by reducing inflammatory mediators and altering metabolite concentrations, resulting in both anti\u2010inflammatory and anti\u2010oxidative effects. The aim was to investigate whether preoperative cryocompression would (1) maintain deep tissue hypothermia during the surgical procedure, (2) attenuate inflammatory response and tissue damage and (3) improve post\u2010operative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The study enroled patients undergoing total knee arthroplasty (TKA) surgery who were randomly assigned to either the control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200950) receiving post\u2010operative cryocompression therapy, or the intervention group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200950) receiving both preoperative and post\u2010operative cryocompression. Exclusion criteria: coagulation\/psychiatric disorders. Inclusion criteria: monolateral primary Kellgren\u2013Lawrence Grade IV knee osteoarthritis. Multiple outcomes, including patient\u2010reported outcomes (PROs), discharge milestones, cutaneous\/osseous temperature and inflammatory biomarkers, were assessed. The primary end point was the difference in inflammatory markers across cohorts, while secondary end points included differences in pain, patient\u2010reported outcome measures (PROMs) and range of motion (ROM). Chi\u2010square test was used for categorical variables and the Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      \u2010test for continuous variables. The minimally clinically important difference was calculated using the 0.5\u2009SD approach. Linear mixed\u2010effects models analyzed the differences in inflammatory markers between the cohorts over time. The alpha value was set at 0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Differences between the contralateral and the operated knee skin temperatures (\n                      <jats:italic>Z<\/jats:italic>\n                      \u2009=\u2009\u22124.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), as well as between the contralateral knee skin temperature and the operated knee bone temperature (\n                      <jats:italic>Z<\/jats:italic>\n                      \u2009=\u2009\u22124.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were found. (2) Erythrocyte sedimentation rate was lower in the intervention group on post\u2010operative Days 1 and 2 compared to the control group. Fibrinogen had a greater increase from preoperative to post\u2010operative in the control group (\n                      <jats:italic>U<\/jats:italic>\n                      \u2009=\u2009746.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). (3) Higher ROM (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and shorter time to reach the rehabilitation milestones to discharge (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) were found in the intervention group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperative cryocompression therapy before TKA might reduce early post\u2010operative inflammation, accelerate rehabilitation milestones, and improve early ROM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Levels of Evidence<\/jats:title>\n                    <jats:p>Level IV.<\/jats:p>\n                  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