Continuous-flow cold therapy for outpatient anterior cruciate ligament reconstruction

Arthroscopy. 1998 Mar;14(2):130-5. doi: 10.1016/s0749-8063(98)70030-1.


This prospective, randomized study evaluated continuous-flow cold therapy for postoperative pain in outpatient arthroscopic anterior cruciate ligament (ACL) reconstructions. In group 1, cold therapy was constant for 3 days then as needed in days 4 through 7. Group 2 had no cold therapy. Evaluations and diaries were kept at 1, 2, and 8 hours after surgery, and then daily. Pain was assessed using the VAS and Likert scales. There were 51 cold and 49 noncold patients included. Continuous passive movement (CPM) use averaged 54 hours for cold and 41 hours for noncold groups (P=.003). Prone hangs were done for 192 minutes in the cold group and 151 minutes in the noncold group. Motion at 1 week averaged 5/88 for the cold group and 5/79 the noncold group. The noncold group average visual analog scale (VAS) pain and Likert pain scores were always greater than the cold group. The noncold group average Vicodin use (Knoll, Mt. Olive, NJ) was always greater than the cold group use (P=.001). Continuous-flow cold therapy lowered VAS and Likert scores, reduced Vicodin use, increased prone hangs, CPM, and knee flexion. Continuous-flow cold therapy is safe and effective for outpatient ACL reconstruction reducing pain medication requirements.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetaminophen / therapeutic use
  • Adult
  • Ambulatory Surgical Procedures*
  • Analgesics / therapeutic use
  • Analgesics, Opioid / therapeutic use
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries
  • Arthroscopy*
  • Cryotherapy / instrumentation
  • Cryotherapy / methods*
  • Drug Combinations
  • Endoscopy*
  • Female
  • Humans
  • Hydrocodone / therapeutic use
  • Male
  • Motion Therapy, Continuous Passive
  • Oxycodone / therapeutic use
  • Pain Measurement
  • Pain, Postoperative / therapy*
  • Plastic Surgery Procedures
  • Prospective Studies
  • Time Factors


  • Analgesics
  • Analgesics, Opioid
  • Drug Combinations
  • acetaminophen, hydrocodone drug combination
  • Acetaminophen
  • Hydrocodone
  • Oxycodone