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Comparison of Various Icing Times in Decreasing Bone Metabolism and Blood Flow in the Knee

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois

Richard L. Illgen, MD

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois

Richard W. Meyer

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois

Peter J. Torok, MD

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois

Malcolm D. Cooper, MD

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois

Bruce Reider, MD

Section of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois

In a previous study we used technetium-99m bone scans to show that cooling a knee for 20 minutes with a standard ice wrap will decrease soft tissue blood flow by a mean of 26%, and skeletal blood flow and me tabolism by 19%. The present study examined the ef fects of shorter and longer icing periods to determine minimum cooling time for a measurable and consistent decrease, and time to produce maximal decrease within a safe period of icing (<30 minutes). Thirty-eight sub jects were studied. An ice wrap was applied to one knee for an assigned time (5, 10, 15, 20, or 25 minutes). Triple-phase bone scans of knees were obtained; mean percentages of decrease in the iced knee for each of the five time groups at each of the three phases of the bone scan were calculated and compared. Mean decreases of 11.1 % in soft tissue blood flow, and 5.1% in skeletal metabolism and blood flow were measured at 5 min utes ; maximums of 29.5% and 20.9%, respectively, were obtained at 25 minutes. A small but consistent decrease in soft tissue blood flow and skeletal blood flow and metabolism in a knee appear to be obtained with as little as 5 minutes of ice application. This effect is time-dependent and can be enhanced three- to four fold by increasing the ice application time to 25 minutes.

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