***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This prospect i ve , controlled study compared cold compressive dressings with wool and crepe in the postoperative management of patients undergoing total knee replacement ( TKR ) . Forty TKR patients were assessed for  blood loss , pain , swelling , and range of motion . Patients in the cold compression group had less blood loss through suction drainage ( 982 mL versus 768 mL ) . A higher proportion of patients in the treatment group did not require blood transfusion postoperatively . Mean opiate requirements were lower in the cold compression group ( 0.57 versus 0.71 mg/kg/48 hours ) . The cold compression device appeared to reduce blood loss and pain following TKR Sixty patients undergoing total knee replacement were r and omized to receive either a cold compression dressing ( Cryo/Cuff , Aircast , UK ) or a modified Robert Jones b and age immediately after surgery . The cold compression dressing was used for a minimum of 6 h per day throughout the hospital stay , and the modified Robert Jones b and age remained in place for 48 h from the time of operation . The 2 groups of patients were compared during their hospital stay for blood loss , range of movement , pain scores and need for analgesia . No difference was found between the 2 groups except for less blood loss in the surgical drains in the cold compression group ( P<0.05 ) . Postoperative complications were seen in both groups , but no complication was associated with either the cold compression dressing or the modified Robert Jones b and age . RésuméEtude r and omisée de 60 patients qui , immédiatement après une arthroplastie totale du genou ont eu soit un pansement compressif froid de type “ Cryocuff ” soit un pansement compressif de type Robert Jones . Le pansement froid a été utilisé 6 heures par jour pendant la durée de l'hospitalisation t and is que le pansement compressif de type Robert Jones a été laisse en place pendant 48 heures après l'opération . Aucune différence statistiquement significative n'a pu être mise en évidence entre les deux groupes , à l'exception des pertes sanguines dans le drainage , moins importantes dans le premier groupe de patients . Nous avons eu des complications post opératoires dans les deux groupes mais aucune corrélation n'a pu être établie entre ces complications et le type de b and age appliqué BACKGROUND AND PURPOSE Owing to a scarcity of clinical research , evidence -based clinical guidelines are not available to guide physiotherapy rehabilitation after total knee replacement surgery . This is despite the fact that , annually , over 20000 patients in Australia , over 300 000 patients in North America and 36 000 patients in the UK potentially require rehabilitation at this time to regain functional independence and to resume recreational and work-related physical activities . This survey of clinicians aim ed to describe st and ard ( usual ) care after total knee replacement in Australia and to provide possible explanations for practice variance , if such variation exists . METHOD A nationwide postal survey involving public and privately funded hospital physiotherapy departments was conducted . Purposive sampling was used to r and omly select hospitals from the National Joint Replacement Registry . A series of closed and open-ended protocol -based questions were asked . RESULTS A response rate of 65 % ( 65/100 ) was obtained . Elements of consistency and diversity across the acute and post-acute phases were evident . Consistent findings included the provision of gait retraining and exercise prescription in the acute period , the requirement for independent ambulation as a criterion for discharge from acute care and the routine referral to ongoing outpatient or community-based physiotherapy . Less consistency was reported for the use of continuous passive motion and cryotherapy  in the acute phase , the modes of ongoing rehabilitation , discharge from rehabilitation criteria and the tools for measuring outcomes . Both institutional and non-institutional factors appeared to explain the demonstrated practice variation . CONCLUSIONS In order to propagate evidence -based practice guidelines and uniformity in care , well- design ed clinical trials are required to identify cost-effective rehabilitation programmes after total knee replacement Three rehabilitation modalities relating to in-hospital postoperative care following unilateral total knee arthroplasty ( UTKA ) were studied regarding their effect on pain management and UTKA outcome : ( 1 ) continuous passive motion ( CPM ) ; ( 2 ) CPM with transcutaneous electrical nerve stimulation ( TENS ) ; and ( 3 ) CPM with continuous cooling pad ( CCP ) . Phase I : CPM .  Twenty-two UTKA patients were r and omized into two postoperative care groups : ( 1 ) 12 with CPM ; and ( 2 ) 10 with no CPM .  Total hospitalization pain medication consumption was significantly less for the CPM group ( P less than .05 ) . Phase II : CPM With TENS .  Forty-eight UTKA patients were r and omized into three postoperative care groups : ( 1 ) 18 with an ipsilateral thigh TENS unit delivering sensory threshold stimulation ; ( 2 ) 18 with a subthreshold TENS unit ; and ( 3 ) 12 with no TENS unit . All groups used CPM . No significant difference was found regarding pain medication consumption . Phase III : CPM With CCP .  Thirty consecutive UTKA patients were divided into two postoperative care groups : ( 1 ) 15 with a CCP unit ; and ( 2 ) 15 with no CCP unit . Both groups used CPM . No significant difference was found regarding total or intramuscular hospitalization pain medication consumption . However , oral hospitalization pain medication consumption was significantly less for the CCP group ( P less than .01 ) . This postoperative UTKA study demonstrates significantly decreased total in-hospital pain medication consumption when comparing CPM vs no CPM , significantly decreased oral in-hospital pain medication consumption when comparing CPM with CCP vs CPM without CCP , but no difference when comparing CPM with TENS vs CPM without TENS . ( ABSTRACT TRUNCATED AT 250 WORDS Fifty total hip arthroplasty ( THA ) patients and 24 total knee arthroplasty ( TKA ) patients were r and omized in a controlled study to examine the effects of cold therapy ( via thermal blankets ) in the postoperative period . The postoperative hospital stay was significantly shorter for the cold-therapy ( 50 degrees F ) compared with control ( 70 degrees F ) groups ( by 1.4 days , P = 0.03 ) for THA patients . There was a similar but nonsignificant trend observed in the TKA groups ( 1.5 days shorter , P = 0.19 ) . Total knee arthroplasty patients using cold therapy  achieved independent ambulation an average of 1 day sooner than TKA control patients , but this difference did not reach statistical significance ( P = 0.08 ) . There were no statistically significant differences between the control groups or the test groups for both THA and TKA patients in narcotic usage , postoperative range-of-motion ( ROM ) , or rate of progression of ROM Most literature reporting the impressive results from knee and hip replacement derives from international data . Few Australian studies have comprehensively compared outcomes after joint replacement up to 1 year . This paper compares the patterns of recovery across physical and patient-centred outcomes following knee or hip replacement in an Australian cohort . One hundred and twenty-two consecutive patients undergoing knee or hip replacement were prospect ively followed . Serial assessment s were conducted ( preoperatively , and 2 , 6 , 12 , 26 and 52 weeks post-surgery ) . Joint pain , patient 's global improvement , timed mobility , and complications were monitored . English-proficient patients completed WOMAC ( Western Ontario and McMaster Universities Osteoarthritis Index ) and SF-36v2 ( Medical Outcomes Short-Form 36 version 2 ) question naires . At 1 year , 81 % ( 55 knee , 44 hip ) were available for follow-up . Significant , large improvements ( up to 254 % ) were evident for most outcomes . Global improvement was reported by 97 % . Recovery for both surgical groups was greatest within the first 26 weeks , but hip patients improved more quickly in most outcomes . Wound disturbances were the most common complication ( 23 in total , 23 % ) and 13 patients ( 13 % ) were readmitted for complications . Recovery patterns were similar to that observed elsewhere . The physical and patient-centred outcomes provide a useful Australian reference for clinicians of the temporal aspects of recovery as well the differences between hip and knee surgeries . Complication and readmission rates appeared high , possibly partly explained by the rigorous capture method Cryotherapy is a common modality used after arthroscopic procedures . The current authors investigated whether regions deeper than the lateral gutter experience similar temperature reductions with cryotherapy , supporting a more global temperature effect on the synovium . Thermocouple probes were arthroscopically placed intraarticularly in the medial gutter and suprapatellar pouch after routine knee arthroscopy . Twelve patients were divided into two groups for temperature measurement during 2 hours . Ice was applied only for the first hour in Group 1 ( n = 6 ) and only for the second hour in Group 2 ( n = 6 ) . The medial gutter and suprapatellar pouch had significant decreases ( average , 2.7 ° –5 ° C ) in the temperature when ice was applied and a significant increase ( average , 1.7 ° –3 ° C ) in the temperature without ice .  Also , the temperatures in the medial gutter and suprapatellar pouch correlated with each other . At 1 hour , the mean difference  between ice versus  no ice was on average 6 ° C.  Cryotherapy globally decreased intraarticular temperature in the absence of hemarthrosis Of all arthroscopic procedures , lateral retinacular release carries the greatest potential for morbidity . Complication rates of up to 7.2 % have been reported , secondary to intraoperative and postoperative hematoma formation . A prospect i ve double-blind study was conducted in which patients were r and omly assigned to one of two groups treated with or without cold therapy for 24 hours postoperatively , subsequent to arthroscopic lateral retinacular release utilizing electrosurgery . Seventy-four percent of the patients treated with cold therapy had good to excellent results postoperatively , and none had significant complications . Thirty-two percent of the patients treated without cold therapy had good to excellent results postoperatively , and two patients experienced significant complications in this group In spite of its widespread use after orthopaedic procedures , the literature evaluating the clinical efficacy of cryotherapy is controversial . The purpose of this prospect i ve r and omized trial was to compare two different temperatures for administering cryotherapy  after total knee arthroplasty with regards to short-term postoperative outcomes . Sixty-four subjects were assigned either the 45 degrees F group or the 75 degrees F group . Subjects in the 45 degrees group were as likely to report a lower pain score at the time of follow-up compared to the 75 degrees group . Our results demonstrate no additional analgesic effect associated with the lower temperature of cryotherapy . Postoperative narcotic consumption , postoperative drainage , self-reported knee function , and range of motion were not affected by the different cryotherapy temperatures . No adverse effects were reported with the cryotherapy treatment OBJECTIVE Increasing attention has been given to the assessment of patient satisfaction as a way to monitor quality of care in hospital setting s. Postoperative patient satisfaction has been thought to be related to level of pain intensity , expectations of outcome , perceived concern by the staff , and helpfulness of treatments . The aim of this study is to develop a simple , reliable measure to assess pain and satisfaction in postsurgical patients and to examine factors related to patient satisfaction . DESIGN A satisfaction question naire was developed for this study and administered to 119 patients who had undergone a major orthopedic surgical procedure . The majority of the patients were diagnosed with osteoarthritis and reported moderate to severe preoperative pain . The 13-item measure was found to be reliable ( test-retest r = .86 ; interexaminer r = .98 ) , valid ( exploratory factor analyses ; intercorrelations ) , and easy to administer . RESULTS Results showed that the majority of the patients were satisfied with their care ( 91 % ) , postoperative pain intensity ( 94 % ) , and the way they were treated by the physicians and nurses ( 98 % ) . Patients with low postoperative pain ratings who perceived that the physicians and nurses showed concern with how much pain they were feeling reported greatest satisfaction with their care ( p < .001 ) . In general , lower postoperative pain ratings were the best predictors of satisfaction and helpfulness of treatment . Preoperative pain status , expected level of postoperative pain , and time waiting for pain medication after a request was made were not significantly correlated with ratings of postoperative pain or satisfaction . CONCLUSIONS These results highlight the important influence of adequate treatment of postoperative pain and perceived concern by the hospital staff on patient satisfaction Ninety consecutive patients undergoing primary knee arthroplasty received local cryotherapy 72 hours after surgery for pain relief . Thermal-pad circulating temperatures were r and omly assigned to 50 degrees , 60 degrees , or 70 degrees F ( room temperature ) . Pain relief was monitored using patient-controlled analgesia machines . The amount of morphine received and number of attempts per hour were statistically analyzed with relation to temperature group , age , sex , weight , side , and diagnosis . The amount of morphine injected was positively correlated to the number of attempts per hour and moderately correlated to body weight . There was no correlation between thermal-pad temperature or any other parameter and the amount of morphine injected after surgery The efficacy of a cold compressive dressing after total knee arthroplasty ( TKA ) was prospect ively studied in 105 knees in 76 patients . All components were cemented . All patients were placed in continuous passive motion machines after operation . A cold compressive Cryocuff dressing was applied to 50 knees after operation 
    Output:
    
Cryotherapy result ed in small benefits in blood loss and discharge knee range of motion .
There were no benefits in transfusion and analgesia requirements , pain , swelling , length of stay , and gains in knee range of motion after discharge .
Despite some early gains , cryotherapy after TKA yields no apparent lasting benefits .
The current evidence does not support the routine use of cryotherapy after TKA