***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 This article describes a retrospective study that assessed 52 consecutive patients who underwent total knee arthroplasty ( TKA ) between January 1 , 1992 and September 15 , 1992 . Thirty-three patients underwent TKA  and received cold therapy pads placed over a thin dressing in the operating room . Nineteen patients underwent TKA  using an identical operative and postoperative procedure , but did not receive continuous cold therapy . Continuous cold therapy consisted of two sterile plastic pads connnected by rubber hoses containing cool water from an electric main unit that maintained a constant temperature of 42 degrees F for the immediate postoperative period . Cold therapy pads were used an average of 3 days and removed with the first dressing change . Patients who had continuous cold therapy averaged a 200 cc decrease in postoperative blood loss . There was no significant difference in the amount of narcotic use , transfusion requirements , or hospital stay between the two groups . Postoperative swelling and range of motion were not consistently recorded . Twenty-eight other variables also examined not significant . Based on these results , we can not recommend continuous cold therapy or justify the extra expense for all patients who undergo TKA BACKGROUND The use of cryotherapy in the management of acute soft tissue injury is largely based on anecdotal evidence . Preliminary evidence suggests that intermittent cryotherapy applications are most effective at reducing tissue temperature to optimal therapeutic levels . However , its efficacy in treating injured human subjects is not yet known . OBJECTIVE To compare the efficacy of an intermittent cryotherapy treatment protocol with a st and ard cryotherapy treatment protocol in the management of acute ankle sprains . SUBJECTS Sportsmen ( n = 44 ) and members of the general public ( n = 45 ) with mild/moderate acute ankle sprains . METHODS Subjects were r and omly allocated , under strictly controlled double blind conditions , to one of two treatment groups : st and ard ice application ( n = 46 ) or intermittent ice application ( n = 43 ) . The mode of cryotherapy was st and ardised across groups and consisted of melting iced water ( 0 degrees C ) in a st and ardised pack . Function , pain , and swelling were recorded at baseline and one , two , three , four , and six weeks after injury . RESULTS Subjects treated with the intermittent protocol had significantly ( p<0.05 ) less ankle pain on activity than those using a st and ard 20 minute protocol ; however , one week after ankle injury , there were no significant differences between groups in terms of function , swelling , or pain at rest . CONCLUSION Intermittent applications may enhance the therapeutic effect of ice in pain relief after acute soft tissue injury Abstract In a prospect i ve study C-reactive protein ( CRP ) and interleukin-6 ( IL-6 ) measurements were taken serially in 30 patients before and after 20 total hip arthroplasties ( THR ) and 10 total knee arthroplasties ( TKR ) . There were no peri- and postoperative complications . Postoperatively the IL-6 serum concentration increased rapidly and peaked 6 h postoperatively at maximum levels ( 399±140 pg/ml ) . There was a mean half-life of 15 h and thereafter a rapid return to normal concentrations . In comparison , the postoperative CRP concentration rose more slowly and reached maximum levels ( 138±54 mg/l ) on the second postoperative day . There was thereafter a slow descent with a mean half-life of 62 h. There was no significant difference between the patients with THR and those with TKR ( P>0.05 ) . IL-6 is therefore a superior marker for the inflammatory phase after THR and TKR.Résumé Nous avons contrôlé la ” C-Reactive Protein ” ( CRP ) et l’”Interieukin-6 ” ( IL-6 ) chez 30 patients avant et après l’implantation de 20 prothèses totales de la hanche et 10 prothèses totales du genou .  L’évolution péri- et postopératoire chez tous les patients était sans complications . Les valeurs de la CRP étaient déterminées par turbidimétrie immunologique et les valeurs de l’IL-6 étaient déterminées par dosage immunologique des enzymes . La concentration de IL-6 dans le sérum augmentait très vite après l’opération et atteignait , 6 h après , ses valeurs maximales . Par contre les concentrations du CRP augmentaient moins vite et atteignaient leurs valeurs maximales seulement le 2’jour après l’opération . La détermination de IL-6 s’avère très adaptée pour le contrôle de l’évolution chimique après implantation d’une prothèse totale We carried out a prospect i ve r and omised study to evaluate the blood loss in 60 patients having a total knee arthroplasty and divided r and omly into two equal groups , one having a computer-assisted procedure and the other a st and ard operation . The surgery was carried out by a single surgeon at one institution using a uniform approach . The only variable in the groups was the use of intramedullary femoral and tibial alignment jigs in the st and ard group and single tracker pins of the imageless navigation system in the tibia and femur in the navigated group . The mean drainage of blood was 1351 ml ( 715 to 2890 ; 95 % confidence interval ( CI ) 1183 to 1518 ) in the computer-aided group and 1747 ml ( 1100 to 3030 ; CI 1581 to 1912 ) in the conventional group . This difference was statistically significant ( p = 0.001 ) . The mean calculated loss of haemoglobin was 36 g/dl in the navigated group versus 53 g/dl in the conventional group ; this was significant at p < 0.00001 . There was a highly significant reduction in blood drainage and the calculated Hb loss between the computer-assisted and the conventional techniques . This allows the ordering of less blood before the operation , reduces risks at transfusion and gives financial saving .  Computer-assisted surgery may also be useful for patients in whom blood products are not acceptable Cryotherapy has historically been used as a treatment following knee surgery . In the literature , there is little evidence of beneficial effects which support this practice . This study examined the effects of cryotherapy treatments on 45 subjects following minor arthroscopic knee surgery .  Subjects were r and omized to one of two treatment groups and the assessor remained blind to treatment group allocation . Subjects performed a 1-week home program of either cryotherapy and exercises or exercises alone . One week following surgery , a statistically significant difference was found between the groups for the affective dimension of the McGill pain question naire , medication consumption , compliance , and weight-bearing status . No significant differences were found between the groups for other outcome variables . These results indicate that the addition of cryotherapy to a regime of exercises following arthroscopic knee surgery produced benefits of increased compliance , improved weight-bearing status , and lower prescription medication consumption The aim of this prospect i ve , r and omized , and controlled study was to evaluate the efficacy of cold compressive dressings ( Cryo/Cuff ) and epidural anesthesia ( EDA ) in the postoperative management of primary unicondylar knee arthroplasty . Sixty patients ( 61 knees ) were r and omized into 3 groups . No significant difference between groups was detected with respect to subjective pain , bleeding , swelling , range of motion , and function . The consumption of morphine was , however , significantly higher in the control group the first 24 hours than both the EDA group ( P < .001 ) and the Cryo group ( P = .028 ) . There was no significant difference in morphine consumption between the 2 treatment groups . Based on the results of this study , Cryo/Cuff seems to be a rational , effective , risk-free , and well-tolerated alternative to EDA to reduce pain and morphine after unicondylar knee arthroplasty The objective of this study was to investigate the effect of continuous long-term application of a combined cooling and compression system ( Cryo/Cuff , Aircast Inc. , Summit . New Jersey , USA ) on postoperative swelling , range of motion ( ROM ) , pain , consumption of analgesics , and return of function  after anterior cruciated ligament ( ACL ) reconstruction . We compared the cold-compression system with traditional ice therapy . There were 44 patients in the series ( aged 15–40 year _ who were r and omly assigned to a  control group ( ICE )  or a  study group  ( CC ) . The ICE group consisted of 23 patients ( aged 24.2±4.5 years ) ; the CC group consisted of 21 patients ( aged 24.8±5.6 years ) . The ICE group received ice bags postoperatively ; the CC group was provided with the Cryo/Cuff during the 14-day hospital stay . Girth , ROM , pain score ( visual analog scale ) , and consumption of analgesics were determined on postoperative days 1 , 2 , 3 , 6 , 14 , and 28 . Twelve weeks after surgery , isokinetic testing was performed , and the functional knee score was determined . In the CC group , significantly less swelling was observed ( P<0.035 ) . These patients also reported less pain and had a significantly reduced consumption of analgesics ( P<0.04 ) . On all examination days , ROM in the CC group was up to 17 ° greater than in the ICE group ( P<0.02 ) . The functional knee score was singificantly increased in the CC group ( P=0.025 ) . The results from our study document the advantages of conitnous cold-compression therapy over cold alone following ACL Pain and swelling , which may lead to inhibition of the extensor mechanism and ultimately a delay in rehabilitation , are common complications of knee arthroscopy .  Cryotherapy is the most often used means of decreasing both knee edema and discomfort . A number of methods have been used to provide cold pressure dressings , including ice and elastic b and ages . Commercial devices , such as the Cryo/Cuff , also have been developed to provide similar beneficial effects . This article describes a multicenter r and omized study undertaken to determine whether the Cryo/Cuff or the ice and elastic b and age offers the greatest convenience and relief of pain .  One hundred two patients between the ages of 18 and 65 scheduled to undergo knee arthroscopy were enrolled . Postoperatively , the Cryo/Cuff patients required significantly less pain medication than those patients using the ice and elastic wrap . The Cryo/Cuff patients also expressed a high level of satisfaction with the effectiveness and convenience of the therapy . There were no differences between either group in the amount of pain reported , or preoperative and postoperative examinations in regard to knee range of motion and thigh circumference . These results indicate that the Cryo/Cuff is a useful adjunct in the rehabilitation of knee arthroscopy patients 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 
    Output:
    
No significant benefit were found for analgesia use , swelling or length of stay .