Comparison of Results of Local Cryotherapy Obtained with the use of Medical Devices and with the use of Ice in Patients After Reconstruction of the Anterior Cruciate Ligament in the Context of guaranteed Healthcare Services

Abstract

Introduction: The development of innovative medical technologies is associated with the need to evaluate the procedures included in the guaranteed service basket, with particular emphasis on assessing currently available medical procedures in terms of their clinical effectiveness. The paper constitutes a critical review of literature by comparing the results of studies found as a result of a search in four online databases. Aim: The main purpose of this paper is to compare the clinical effectiveness of two cryotherapy methods: medical devices and ice treatments in patients after anterior cruciate ligament reconstruction. Material and Methods: The scientific reports were reviewed through the Medline, Embase, Cochrane Library and PEDro databases, in accordance with the designed search strategy using the following keywords: Anterior Cruciate Ligament Reconstruction, Cryostimulation, Cryotherapy, Cold Therapy, Cold Stimulation. Results: As a result of the search, a total of 170 publications were found, of which 4 studies were included in the analysis. Statistically significant therapy outcomes in the context of analgesia with a predominance of medical devices were obtained in two of four studies. However, in the context of anti-edema action only in one of the two studies, the statistically significant result was higher in the group of patients who used the medical device with simultaneous compression. Conclusions: 1. The results of the trials suggest that devices utilizing cryocompression have the highest efficiency in the case of analgesic and anti-edema action after arthroscopic reconstruction of ACL and are positively received by patients who use this form therapy. However, the results of randomized trials are not sufficient to draw definitive conclusions about the effectiveness of this form of therapy. 2. The need to amend the provisions of the relevant legal acts regulating the conditions for the provision of services and determining the criteria for the selection of offers in the procedure regarding the conclusion of contracts for the provision of medical services. 3. The need to using a uniform terminology regarding the name of the treatments utilizing low temperatures. 4. The need to conduct large multicentre randomized clinical trials with standardized intervention.