{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:59:25Z","timestamp":1781085565781,"version":"3.54.1"},"reference-count":33,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose: Cryo-compression benefits after knee arthroplasty appear short-lived. Evidence in unicompartmental knee arthroplasty (UKA) is particularly scarce. We aimed to assess 6-week cryo-compression on pain (including oxycodone consumption), function, and quality of life (QoL) at 6 weeks following UKA compared with standard care.Methods: In this single-center, single-blind randomized controlled trial (NCT05572359), adults scheduled for UKA were randomly assigned (1:1) to the regular or cryo-compression group. The cryo-compression group was instructed to use the cold compression brace 5 times daily for 6 weeks. Primary outcome (Numeric Rating Scale [NRS] pain at rest) and secondary outcomes (NRS pain during loading, Knee Injury and Osteoarthritis Outcome Score-subscales, Oxford Knee Score, Work, Osteoarthritis and joint-Replacement Questionnaire [WORQ], physical tests, EuroQol 5-Dimensions 5-Level [EQ5D-5L]) were measured preoperatively and at 6 weeks. Oxycodone consumption was recorded daily.Results: At 6 weeks, there was no between-group difference in pain at rest (mean difference 0.1 points, CI \u20130.6 to 0.9). The cryo-compression group consumed 46% less oxycodone over the 6 weeks (CI 9\u201368), with an absolute median difference of 3.5 5-mg tablets in total. WORQ and EQ5D-5L index-scores improved more in the cryo-compression group (8.7 points, CI 0.7\u201316.6, and 0.10 points, CI 0.03\u20130.2, respectively), but neither reached the minimal clinically important difference (13 and 0.11).Conclusion: 6-week cryo-compression following UKA demonstrated no differences in pain at rest or functional and QoL-related outcomes. Oxycodone consumption was lower in the cryo-compression group, although absolute differences were small.<\/jats:p>","DOI":"10.2340\/17453674.2026.45963","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:14:12Z","timestamp":1781082852000},"source":"Crossref","is-referenced-by-count":0,"title":["6-week cryo-compression therapy and opioid use after unicompartmental knee arthroplasty with comparable pain scores: a secondary analysis of a randomized controlled trial"],"prefix":"10.2340","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5313-6165","authenticated-orcid":false,"given":"Hannah","family":"Biemans","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid J","family":"De Vries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinoud W","family":"Brouwer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"158239","doi-asserted-by":"crossref","unstructured":"Noticewala M S, Geller J A, Lee J H, Macaulay W. Unicompartmental knee arthroplasty relieves pain and improves function more than total knee arthroplasty. J Arthroplasty 2012; 27(8 Suppl): 99-105. doi: 10.1016\/j.arth.2012.03.044.","DOI":"10.1016\/j.arth.2012.03.044"},{"key":"158240","doi-asserted-by":"crossref","unstructured":"Holm B, Kristensen M T, Bencke J, Husted H, Kehlet H, Bandholm T. Loss of knee-extension strength is related to knee swelling after total knee arthroplasty. Arch Phys Med Rehabil 2010; 91: 1770-6. doi: 10.1016\/j.apmr.2010.07.229.","DOI":"10.1016\/j.apmr.2010.07.229"},{"key":"158241","doi-asserted-by":"crossref","unstructured":"Levy N, Quinlan J, El-Boghdadly K, Fawcett W J, Agarwal V, Bastable R B, et al. An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients. Anaesthesia 2020; 76(4): 520-36. doi: 10.1111\/anae.15262.","DOI":"10.1111\/anae.15262"},{"key":"158242","doi-asserted-by":"crossref","unstructured":"Aggarwal A, Adie S, Harris I A, Naylor J. Cryotherapy following total knee replacement. Cochrane Database Syst Rev 2023; 9(9): CD007911. doi: 10.1002\/14651858.CD007911.pub3.","DOI":"10.1002\/14651858.CD007911.pub3"},{"key":"158243","doi-asserted-by":"crossref","unstructured":"Brouwers H F G, de Vries A J, van Zuilen M, van Kouswijk H W, Brouwer R W. The role of computer-assisted cryotherapy in the postoperative treatment after total knee arthroplasty: positive effects on pain and opioid consumption. Knee Surg Sports Traumatol Arthrosc 2022; 30(8): 2698-706. doi: 10.1007\/s00167-021-06568-x.","DOI":"10.1007\/s00167-021-06568-x"},{"key":"158244","doi-asserted-by":"crossref","unstructured":"Thijs E, Schotanus M G M, Bemelmans Y F L, Kort N P. Reduced opiate use after total knee arthroplasty using computer-assisted cryotherapy. Knee Surg Sports Traumatol Arthrosc 2019; 27(4): 1204-12. doi: 10.1007\/s00167-018-4962-y.","DOI":"10.1007\/s00167-018-4962-y"},{"key":"158245","doi-asserted-by":"crossref","unstructured":"Holmstr\u00f6m A, H\u00e4rdin B C. Cryo\/cuff compared to epidural anesthesia after knee unicompartmental arthroplasty: a prospective, randomized and controlled study of 60 patients with a 6-week follow-up. J Arthroplasty 2005; 20(3): 316-21. doi: 10.1016\/j.arth.2004.09.043.","DOI":"10.1016\/j.arth.2004.09.043"},{"key":"158246","doi-asserted-by":"crossref","unstructured":"Kuyucu E, B\u00fclb\u00fcl M, Kara A, Ko\u00e7yi\u011fit F, Erdil M. Is cold therapy really efficient after knee arthroplasty? Ann Med Surg (Lond) 2015; 4(4): 475-8. doi: 10.1016\/j.amsu.2015.10.019.","DOI":"10.1016\/j.amsu.2015.10.019"},{"key":"158247","doi-asserted-by":"crossref","unstructured":"Lee B, Yoon D, Yim J. Effects of an early exercise program with cryotherapy on range of motion, pain, swelling, and gait in patients with total knee arthroplasty: a randomized controlled trial. J Clin Med 2024; 13(5): 1420. doi: 10.3390\/jcm13051420.","DOI":"10.3390\/jcm13051420"},{"key":"158248","doi-asserted-by":"crossref","unstructured":"Marinova M, Sundaram A, Holtham K, Ebert J R, Wysocki D, Meyerkort D, et al. The role of a cryocompression device following total knee arthroplasty to assist in recovery: a randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 2023; 31(10): 4422-9. doi: 10.1007\/s00167-023-07455-3.","DOI":"10.1007\/s00167-023-07455-3"},{"key":"158249","doi-asserted-by":"crossref","unstructured":"Su E P, Perna M, Boettner F, Mayman D J, Gerlinger T, Barsoum W, et al. A prospective, multi-center, randomised trial to evaluate the efficacy of a cryopneumatic device on total knee arthroplasty recovery. 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Knee 2026; 60: 104325. doi: 10.1016\/j.knee.2026.104325.","DOI":"10.1016\/j.knee.2026.104325"},{"key":"158252","doi-asserted-by":"crossref","unstructured":"Laigaard J, Aljuboori S M, Nikolajsen L, Mathiesen O, Lunn T H, Lindberg-Larsen M, et al. Chronic pain after primary total and medial unicompartmental knee arthroplasty for osteoarthritis: a Danish nationwide cross-sectional survey. Acta Orthop 2025; 96: 814-21. doi: 10.2340\/17453674.2025.44898.","DOI":"10.2340\/17453674.2025.44898"},{"key":"158253","doi-asserted-by":"crossref","unstructured":"de Vries A J, Aksakal H K, Brouwer R W. Effects of 6 weeks of cryotherapy plus compression therapy after total or unicompartmental knee arthroplasty: protocol for a single-centre, single-blind randomised controlled trial. 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Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken) 2011; 63(Suppl 11): S240-S252. doi: 10.1002\/acr.20543.","DOI":"10.1002\/acr.20543"},{"key":"158257","doi-asserted-by":"crossref","unstructured":"de Groot I B, Favejee M M, Reijman M, Verhaar J A, Terwee C B. The Dutch version of the Knee Injury and Osteoarthritis Outcome Score: a validation study. Health Qual Life Outcomes 2008; 6: 16. doi: 10.1186\/1477-7525-6-16.","DOI":"10.1186\/1477-7525-6-16"},{"key":"158258","doi-asserted-by":"crossref","unstructured":"Haverkamp D, Breugem S J, Sierevelt I N, Blankevoort L, van Dijk C N. Translation and validation of the Dutch version of the Oxford 12-item knee questionnaire for knee arthroplasty. Acta Orthop 2005; 76(3): 347-52. doi: 10.1080\/00016470510030814.","DOI":"10.1080\/00016470510030814"},{"key":"158259","doi-asserted-by":"crossref","unstructured":"Kievit A J, Kuijer P P, Kievit R A, Sierevelt I N, Blankevoort L, Frings-Dresen M H. A reliable, valid and responsive questionnaire to score the impact of knee complaints on work following total knee arthroplasty: the WORQ. J Arthroplasty 2014; 29(6): 1169-75.e2. doi: 10.1016\/j.arth.2014.01.016.","DOI":"10.1016\/j.arth.2014.01.016"},{"key":"158260","doi-asserted-by":"crossref","unstructured":"Jakobsen T L, Christensen M, Christensen S S, Olsen M, Bandholm T. Reliability of knee joint range of motion and circumference measurements after total knee arthroplasty: does tester experience matter? 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Value Health 2016; 19(3): 343-52. doi: 10.1016\/j.jval.2016.01.003.","DOI":"10.1016\/j.jval.2016.01.003"},{"key":"158264","doi-asserted-by":"crossref","unstructured":"Kendrick D B, Strout T D. The minimum clinically significant difference in patient-assigned numeric scores for pain. Am J Emerg Med 2005; 23(7): 828-32. doi: 10.1016\/j.ajem.2005.07.009.","DOI":"10.1016\/j.ajem.2005.07.009"},{"key":"158265","doi-asserted-by":"crossref","unstructured":"McCoy C E. Understanding the intention-to-treat principle in randomized controlled trials. West J Emerg Med 2017; 18(6): 1075-8. doi: 10.5811\/westjem.2017.8.35985.","DOI":"10.5811\/westjem.2017.8.35985"},{"key":"158266","doi-asserted-by":"crossref","unstructured":"Laoruengthana A, Chaibhuddanugul N, Rattanaprichavej P, Malisorn S, Tangsripong P, Pongpirul K. Perioperative outcomes of patients who were not candidates for additional nonsteroidal anti-inflammatory drugs in a multimodal pain control regimen for total knee arthroplasty. Clin Orthop Surg 2021; 13(2): 160-7. doi: 10.4055\/cios20154.","DOI":"10.4055\/cios20154"},{"key":"158267","doi-asserted-by":"crossref","unstructured":"Serdarevic M, Striley C W, Cottler L B. Sex differences in prescription opioid use. Curr Opin Psychiatry 2017; 30(4): 238-46. doi: 10.1097\/YCO.0000000000000337.","DOI":"10.1097\/YCO.0000000000000337"},{"key":"158268","doi-asserted-by":"crossref","unstructured":"Laigaard J, Pedersen C, R\u00f8nsbo T N, Mathiesen O, Karlsen A P H. Minimal clinically important differences in randomised clinical trials on pain management after total hip and knee arthroplasty: a systematic review. Br J Anaesth 2021; 126(5): 1029-37. doi: 10.1016\/j.bja.2021.01.021.","DOI":"10.1016\/j.bja.2021.01.021"},{"key":"158269","doi-asserted-by":"crossref","unstructured":"Cheng L J, Chen L A, Cheng J Y, Herdman M, Luo N. Systematic review reveals that EQ-5D minimally important differences vary with treatment type and may decrease with increasing baseline score. 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