Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Sports Medicine - Knee
Abstract number: 25771
TEMPERATURE SENSITIVE RELEASE OF PGE2 AND DIMINISHED ENERGY
REQUIREMENTS IN SYNOVIAL TISSUE WITH POSTOPERATIVE
CRYOTHERAPY - A PROSPECTIVE RANDOMISED STUDY AFTER KNEE
ARTHROSCOPY
Anders STÅLMAN, Elisabeth DUNGNER, Peter ARNER, Li FELLÄNDER-TSAI
Karolinska Institutet, Saltsjöbaden (SWEDEN)
Background: Local external cooling of the postoperative field is a treatment paradigm
aiming for enhanced recovery after joint surgery. It is supposed to reduce pain and
improve mobilization, enabling same day surgery. Hypothesis: Systematic
postoperative cooling and compression after knee arthroscopy will reduce pain and
also be reflected by changes in local levels of metabolic and inflammatory variables
in the synovial membrane. Methods: Forty-four otherwise healthy patients were
randomised to systematic cooling and compression or NO cooling and compression
after knee arthroscopy. Microdialysis of the synovial membrane was performed
postoperatively with measurements of PGE2, glucose, lactate, glycerol, glutamate
and blood flow (ethanol exchange ratio). Local temperature was monitored as well as
postoperative pain (VAS and NRS). Results: Cooling and compression after knee
arthroscopy resulted in significantly lower temperature in the operated knee (skin,
joint capsule and intraarticularly). This diminished energy requirements in synovial
tissue and a temperature sensitive influence on inflammation (PGE2) were shown.
No effect on postoperative pain was detected. Conclusion: Local cryotherapy and
compression after knee arthroscopy significantly lowered local knee temperature
postoperatively. A correlation with synovial PGE 2 and temperature was shown.
Since PGE2 is a pain and inflammatory marker this implicates a positive antiinflammatory
effect induced by postoperative local cooling and compression.
485