{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:54:10Z","timestamp":1790902450145,"version":"4.1.0"},"reference-count":34,"publisher":"PAGEPress Publications","issue":"3","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Transl Myol"],"abstract":"<jats:p>Postoperative pain following patellar fracture surgery may delay rehabilitation and impair functional recovery. While cryotherapy is commonly used, concerns exist regarding its effects on local blood flow. Alternative topical cooling formulations may offer analgesic benefits without prolonged vasoconstriction. In this study, we compared postoperative pain, functional recovery, quality of life, and rescue analgesic consumption among patients receiving traditional ice therapy, ice spray, or Crack Dol\u00ae Foam Spray following surgical fixation of patellar fractures. Ninety patients undergoing surgical fixation for patellar fracture were prospectively enrolled in this non-randomized comparative cohort study and allocated into three groups (n=30 each) based on patient preference and clinical contraindications: ice therapy, ice spray, and Crack Dol\u00ae Foam Spray. Pain intensity (Visual Analogue Scale, VAS), health-related quality of life (SF-12), knee function (KOOS), and rescue analgesic consumption were assessed during postoperative follow-up. Patients in the Crack Dol\u00ae Foam Spray group had significantly lower VAS scores at 7, 30, and 90 days compared with the ice and ice spray groups (p=0.012, p=0.006, and p=0.004, respectively). At 90 days, SF-12 Physical and Mental Component Scores were significantly higher in the Crack Dol\u00ae group (p=0.009 and p=0.014, respectively). KOOS total scores were also significantly higher at 30 and 90 days (p=0.018 and p=0.007, respectively). Rescue analgesic consumption was significantly lower in the Crack Dol\u00ae group (p=0.011). In this prospective, non-randomized comparative cohort study, the use of Crack Dol\u00ae Foam Spray was associated with lower postoperative pain scores, lower rescue analgesic consumption, and better patient-reported functional and quality-of-life outcomes compared with traditional ice therapy and ice spray. Given the non-randomized treatment allocation, these findings should be interpreted as associations rather than evidence of a causal treatment effect. Further randomized controlled trials are needed to confirm these preliminary findings.<\/jats:p>","DOI":"10.4081\/ejtm.2026.15868","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:56:09Z","timestamp":1789131369000},"source":"Crossref","is-referenced-by-count":0,"title":["Crack Dol&lt;sup&gt;\u00ae&lt;\/sup&gt; &lt;i&gt;vs.&lt;\/i&gt; cryotherapy in postoperative pain treatment after patellar fracture fixation"],"prefix":"10.4081","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3669-189X","authenticated-orcid":true,"given":"Luigi","family":"Meccariello","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, AORN San Pio Hospital, Benevento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Predrag","family":"Grubor","sequence":"additional","affiliation":[{"name":"CEO, School of Medicine and Surgery, University of Doboj"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Bosco","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy; Department of Orthopaedics and Traumatology, G.F. Ingrassia Hospital Unit, ASP 6, Palermo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2821-8015","authenticated-orcid":true,"given":"Claudio Domenico","family":"Cobisi","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy; Department of Orthopaedics and Traumatology, G.F. Ingrassia Hospital Unit, ASP 6, Palermo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Cristiano","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging Unit, Studio Radiologico S. Domenico, A. Cristiano Co. S.r.l., Lamezia Terme, Italy; Department of Radiology, Paideia International Hospital, Rome"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Casolaro","sequence":"additional","affiliation":[{"name":"Financial and Management Department, Azienda Sanitaria Locale (ASL) Benevento"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0798-2820","authenticated-orcid":true,"given":"Jacopo","family":"Conteduca","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Traumatology, Vito Fazzi Hospital, Lecce"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rollo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Traumatology, Vito Fazzi Hospital, Lecce"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4403-1100","authenticated-orcid":true,"given":"Dimitra","family":"Melissaridou","sequence":"additional","affiliation":[{"name":"First department of orthopaedics,National and Kapodistrian University of Athens, Attikon University General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8742-5612","authenticated-orcid":true,"given":"Michele","family":"Mercurio","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Trauma Surgery, \"Magna Graecia\" University, \"Mater Domini\" University Hospital, Catanzaro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Camarda","sequence":"additional","affiliation":[{"name":"Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5201-6755","authenticated-orcid":true,"given":"Fernando","family":"De Maio","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Translational Medicine, Section of Orthopaedic and Traumatology, University of Rome Tor Vergata, Roma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rovere","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Translational Medicine, Section of Orthopaedic and Traumatology, University of Rome Tor Vergata, Roma, Italy; Department of Surgical Sciences, Policlinico Tor Vergata University Hospital, Rome"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"250918","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004987"},{"key":"250919","doi-asserted-by":"publisher","DOI":"10.1177\/23259671251320132"},{"key":"250920","doi-asserted-by":"publisher","DOI":"10.1186\/s42836-024-00287-7"},{"key":"250921","doi-asserted-by":"publisher","DOI":"10.1016\/j.fmre.2024.07.008"},{"key":"250922","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.20.00016"},{"key":"250923","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2022.1006908"},{"key":"250924","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci13060918"},{"key":"250925","doi-asserted-by":"publisher","DOI":"10.3390\/plants13213112"},{"key":"250926","doi-asserted-by":"publisher","DOI":"10.1097\/MJT.0000000000000036"},{"key":"250927","doi-asserted-by":"publisher","DOI":"10.26603\/001c.128589"},{"key":"250928","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e318270dfe7"},{"key":"250929","unstructured":"12. 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