Cryotherapy Following Nonknee Arthroplasty

Key Messages

What Is the Issue?

• Joint replacement surgeries remain among the highest-volume inpatient procedures in Canada. This major operation replaces a damaged joint with an artificial implant to relieve severe pain and restore mobility. While joint replacement can significantly improve a patient's quality of life, the recovery phase involves acute pain and swelling at the surgical site that requires postoperative care to improve recovery.
• Cold therapies, such as ice packs, are part of the standard postoperative care and recovery to reduce swelling, inflammation, and pain. Cryotherapy devices are specialized interventions for cold therapy that are designed to offer lower and/or more consistent temperatures than conventional ice packs. However, the clinical effectiveness of cryotherapy after surgical replacement of joints other than the knee is unclear.
• This rapid review was prepared in response to a request for evidence to support decision-making around the use of cryotherapy after nonknee arthroplasty.

What Did We Do?

• Canada’s Drug Agency conducted a rapid review to identify and summarize evidence that evaluated the clinical effectiveness of cryotherapy compared with standard postoperative care in adult patients undergoing nonknee arthroplasty.
• We searched key resources, including journal citation databases, and conducted a focused internet search for relevant evidence published between January 1, 2023, and August 11, 2026.

What Did We Find?

• We found 1 systematic review that evaluated cryotherapy postoperatively in adult patients undergoing total hip arthroplasty and 1 nonrandomized clinical trial that evaluated cryotherapy following carpometacarpal arthroplasty.
• We did not find studies on the clinical effectiveness of cryotherapy versus standard of care for shoulder, elbow, wrist, or ankle joint arthroplasties.
• Compared with standard of care, cryotherapy may be associated with improved pain during the first 2 postoperative days following total hip arthroplasty and 2 weeks after carpometacarpal arthroplasty without increasing the risk of adverse events.
• The included studies did not detect statistically significant differences between cryotherapy and control groups for analgesic use, blood loss, joint function, adverse events, or hospital length of stay.
• The clinical evidence summarized in this rapid review is of low to moderate quality, with substantial concerns regarding selection bias, lack of randomization, intervention masking, and generalizability.

What Does This Mean?

• Health care professionals and decision-makers can use this evidence to inform decisions around the use of cryotherapy after hip and carpometacarpal joint replacements. Low-certainty evidence suggests that cryotherapy might offer short-term pain relief, but patients might not experience benefits in other clinical outcomes.
• Well-designed studies with proper reporting are needed to confirm the clinical effectiveness of cryotherapy versus other cold therapies.