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The American Journal of Sports Medicine 32:441-445 (2004)
© 2004 American Orthopaedic Society for Sports Medicine

Intra-articular Knee Temperature Changes

Ice Versus Cryotherapy Device

Todd A. Warren, NP, ATC, Eric C. McCarty, MD, Airron L. Richardson, BA, Todd Michener, MD and Kurt P. Spindler, MD*

From the Vanderbilt Sports Medicine Center, Department of Orthopaedics & Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee

* Address correspondence to Kurt P. Spindler, MD, Vanderbilt Sports Medicine Center, 2601 Jess Neely Drive, Nashville, TN 37212.

Background: Cryotherapy is commonly applied without research documenting the intra-articular (IA) temperature changes or subject discomfort between ice and a cryotherapy device.

Hypothesis: The null hypothesis is that no difference would be observed in IA temperature decline or subject tolerance between ice and the cryotherapy device in normal knees.

Study Design: Prospective, within-subject controlled clinical trial.

Methods: Twelve subjects had IA temperature in suprapatellar pouch and skin recorded bilaterally after application of cryotherapy versus ice. Subject tolerance was recorded by 10-cm visual analog scale (VAS). Statistical evaluation was by Spearman’s correlation analysis and paired, nonparametric Wilcoxon’s signed rank test.

Results: Both significantly lowered (P < 0.001) skin and IA temperature with median decreases (ice/cryotherapy) at 30 (3.3°C/2.2°C), 60 (12.8°C/7.1°C), and 90 (15.2°C/9.7°C) minutes. However, ice lowered the IA temperature significantly more than the cryotherapy device (P < 0.001) and was more painful by VAS at 30 and 60 minutes (P < 0.01).

Conclusions: Both methods produced large declines in skin and IA temperatures. However, ice was more effective yet resulted in higher pain scores. The authors hypothesize that IA temperatures below a threshold are associated with increased perceived pain.

Key Words: cryotherapy • intra-articular • temperature • knee • ice




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