• 1.

    Slocum BSlocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993; 23:777795.

    • Search Google Scholar
    • Export Citation
  • 2.

    Kim SEPozzi AKowaleski MP, et al. Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Vet Surg 2008; 37:111125.

    • Search Google Scholar
    • Export Citation
  • 3.

    Priddy NHTomlinson JLDodam JR, et al. Complications with and owner assessment of the outcome of tibial plateau leveling osteotomy for treatment of cranial cruciate ligament rupture in dogs: 193 cases (1997–2001). J Am Vet Med Assoc 2003; 222:17261732.

    • Search Google Scholar
    • Export Citation
  • 4.

    Pacchiana PDMorris EGillings SL, et al. Surgical and postoperative complications associated with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998–2001). J Am Vet Med Assoc 2003; 222:219227.

    • Search Google Scholar
    • Export Citation
  • 5.

    Hoelzler MGHarvey RCLidbetter DA, et al. Comparison of perioperative analgesic protocols for dogs undergoing tibial plateau leveling osteotomy. Vet Surg 2005; 34:337344.

    • Search Google Scholar
    • Export Citation
  • 6.

    Grisneaux EPibarot PDupuis J, et al. Comparison of ketoprofen and carprofen administration prior to orthopedic surgery for control of postoperative pain in dogs. J Am Vet Med Assoc 1999; 215:11051110.

    • Search Google Scholar
    • Export Citation
  • 7.

    Sammarco JLConzemius MGPerkowski SZ, et al. Postoperative analgesia for stifle surgery: a comparison of intra-articular bupivacaine, morphine, or saline. Vet Surg 1996; 25:5969.

    • Search Google Scholar
    • Export Citation
  • 8.

    Bergmann HMNolte IKramer S. Comparison of analgesia efficacy of preoperative or postoperative carprofen with or without perincisional mepivacaine epidural anesthesia in canine pelvic or femoral fracture repair. Vet Surg 2007; 36:623632.

    • Search Google Scholar
    • Export Citation
  • 9.

    Smith-Miller CAHarlos LRoszell SS, et al. A comparison of patient pain responses and medication regimens after hip/knee replacement. Orthop Nurs 2009; 28:242249.

    • Search Google Scholar
    • Export Citation
  • 10.

    Kona-Boun JCuvelliez STroncy E, et al. Evaluation of epidural administration of morphine or morphine and bupivacaine for postoperative analgesia after premedication with an opioid analgesic and orthopedic surgery in dogs. J Am Vet Med Assoc 2006; 229:11031112.

    • Search Google Scholar
    • Export Citation
  • 11.

    Kehlet HDahl JB. The value of “multimodal” or “balanced analgesia” in postoperative pain treatment. Anesth Analg 1993; 77:10481056.

    • Search Google Scholar
    • Export Citation
  • 12.

    Woolf CJChong MS. Preemptive analgesia-treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg 1993; 77:362379.

    • Search Google Scholar
    • Export Citation
  • 13.

    Muir WWWiese AJMarch PA. Effects of morphine, lidocaine, ketamine, and morphine-lidocaine-ketamine drug combination on minimum alveolar concentration in dogs anesthetized with isoflurane. Am J Vet Res 2003; 64:11551160.

    • Search Google Scholar
    • Export Citation
  • 14.

    Slingsby SLWaterman-Pearson AE. Analgesia effects in dogs of carprofen and pethidine together compared with the effects of either drug alone. Vet Rec 1993; 148:441444.

    • Search Google Scholar
    • Export Citation
  • 15.

    Millis DL. Getting the dog moving after surgery. J Am Anim Hosp Assoc 2004; 40:429436.

  • 16.

    Kullenberg BYlippa SSoderlund K, et al. Postoperative cryotherapy after total knee arthroplasty: a prospective study of 86 patients. J Arthroplasty 2006; 21:11751179.

    • Search Google Scholar
    • Export Citation
  • 17.

    Ohkoshi YOhkoshi MNagasaki S, et al. The effects of cryotherapy on intraarticular temperature and postoperative care after anterior cruciate ligament reconstruction. Am J Sports Med 1999; 27:357362.

    • Search Google Scholar
    • Export Citation
  • 18.

    Ho SSCoel MNKagawa R, et al. The effects of ice on blood flow and bone metabolism in knees. Am J Sports Med 1994; 22:537540.

  • 19.

    Martin SSSpindler KPTarter JW, et al. Cryotherapy: an effective modality for decreasing intraarticular temperature after knee arthroscopy. Am J Sports Med 2001; 29:288291.

    • Search Google Scholar
    • Export Citation
  • 20.

    Yenari MAHan HS. Influence of hypothermia on post-ischemic inflammation: role of nuclear factor kappa B (NfkappaB). Neurochem Int 2006; 2:164169.

    • Search Google Scholar
    • Export Citation
  • 21.

    Lehmann JFWarren CGScham SM. Therapeutic heat and cold. Clin Orthop Relat Res 1974; 99:207245.

  • 22.

    Woolf SKBarfield WRMerrill KD, et al. Comparison of a continuous temperature-controlled cryotherapy device to a simple icing regimen following outpatient knee arthroscopy. J Knee Surg 2008; 21:1519.

    • Search Google Scholar
    • Export Citation
  • 23.

    Barber FA. A comparison of crushed ice and continuous flow cold therapy. Am J Knee Surg 2000; 13:97101.

  • 24.

    Gibbons CESolan MCRicketts DM, et al. Cryotherapy compared with Robert Jones bandage after total knee replacement: a prospective randomized trial. Int Orthop 2001; 25:250252.

    • Search Google Scholar
    • Export Citation
  • 25.

    Schroder DPassler HH. Combination of cold and compression after knee surgery. A prospective randomized study. Knee Surg Sports Traumatol Arthrosc 1994; 2:158165.

    • Search Google Scholar
    • Export Citation
  • 26.

    Homstrom AHardin BC. Cryo/Cuff compared to epidural anesthesia after knee unicompartimental arthroplasty. J Arthroplasty 2005; 20:312321.

    • Search Google Scholar
    • Export Citation
  • 27.

    Piermattei DLJohnson KA. Section VII: the hind limb. In: An atlas of surgical approaches to the bones and joints of the dog and cat. 4th ed. Philadelphia: WB Saunders Co, 2004; 346349.

    • Search Google Scholar
    • Export Citation
  • 28.

    Murrell JCPsatha EPScott EM, et al. Application of a modified form of the Glasgow pain scale in a veterinary teaching centre in the Netherlands. Vet Rec 2008; 162:403408.

    • Search Google Scholar
    • Export Citation
  • 29.

    Hudson JTSlater MRTaylor L, et al. Assessing repeatability and validity of a visual analogue scale questionnaire for use in assessing pain and lameness in dogs. Am J Vet Res 2004; 65:16341643.

    • Search Google Scholar
    • Export Citation
  • 30.

    Conzemius MGHill CMSammarco JL, et al. Correlation between subjective and objective measures used to determine severity of postoperative pain in dogs. J Am Vet Med Assoc 1997; 210:16191622.

    • Search Google Scholar
    • Export Citation
  • 31.

    Jegger GMarcellin-Little DJLevine D. Reliability of goniometry in Labrador Retrievers. Am J Vet Res 2002; 63:979986.

  • 32.

    Harris JDhupa S. Cryotherapy. Compend Contin Educ Pract Vet 2007; 29:632635.

  • 33.

    Hewitt JDHarrelson HMDailiana Z, et al. The effect of intermittent pneumatic compression on fracture healing. J Orthop Trauma 2005; 19:371376.

    • Search Google Scholar
    • Export Citation
  • 34.

    Park SHSulva M. Effect of intermittent pneumatic soft tissue compression on fracture healing in an animal model. J Bone Joint Surg Am 2003; 85:14461453.

    • Search Google Scholar
    • Export Citation
  • 35.

    Dahl JLi JBring DK, et al. Intermittent pneumatic compression enhances neurovascular ingrowth and tissue proliferation during connective tissue healing: a study in the rat. J Orthop Res 2007; 25:11851192.

    • Search Google Scholar
    • Export Citation
  • 36.

    MacAuley DC. Ice therapy: how good is the evidence? Int J Sports Med 2001; 22:379384.

  • 37.

    Smith JStevens JTaylor M, et al. A randomized, controlled trial comparing compression bandaging and cold therapy in postoperative total knee replacement surgery. Orthop Nurs 2002; 21:6166.

    • Search Google Scholar
    • Export Citation
  • 38.

    Anil SSAnil LDeen J. Challenges of pain assessment in domestic animals. J Am Vet Med Assoc 2002; 220:313319.

  • 39.

    Holton LReid JScott EM, et al. Development of a behavior-based scale to measure acute pain in dogs. Vet Rec 2001; 148:525531.

  • 40.

    D'Amour FESmith DL. A method for determining loss of pain sensation. Am J Physiol 1994; 2:7449.

  • 41.

    Cambridge AJTobias KMNewberry RC, et al. Subjective and objective measurements of postoperative pain in cats. J Am Vet Med Assoc 2000; 217:685690.

    • Search Google Scholar
    • Export Citation
  • 42.

    Conzemius MGEvans RBBesancon MF, et al. Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs. J Am Vet Med Assoc 2005; 226:232236.

    • Search Google Scholar
    • Export Citation
  • 43.

    Quinn MMKeuler NSLu Y, et al. Evaluation of agreement between numerical rating scales, visual analogue scoring scales, and force plate gait analysis in dogs. Vet Surg 2007; 36:360367.

    • Search Google Scholar
    • Export Citation
  • 44.

    Jandi ASSchulman AJ. Incidence of motion loss of the stifle joint in dogs with naturally occurring cranial cruciate ligament rupture surgically treated with tibial plateau leveling osteotomy: longitudinal clinical study of 412 cases. Vet Surg 2007; 36:114121.

    • Search Google Scholar
    • Export Citation
  • 45.

    Enneking WFHorowitz M. The intra-articular effect of immobilization of the human knee. J Bone Joint Surg 1972; 54:973985.

  • 46.

    Hosgood G. Wound repair and specific tissue response to injury. In: Slatter DH, ed. Textbook of small animal surgery. 3rd ed. Philadelphia: WB Saunders Co, 2003;6686.

    • Search Google Scholar
    • Export Citation
  • 47.

    Lineberger JAllen DWilson E, et al. Comparison of radiographic arthritic changes associated with two variations of tibial plateau leveling osteotomy. J Vet Comp Orthop Traumatol 2005; 18:1317.

    • Search Google Scholar
    • Export Citation
  • 48.

    Trumble TNBillinghurst RCBendele AM, et al. Evaluation of changes in vertical ground reaction forces as indicators of meniscal damage after transection of the cranial cruciate ligament in dogs. Am J Vet Res 2005; 66:156163.

    • Search Google Scholar
    • Export Citation
  • 49.

    Monk MLPreston CAMcGowan CM. Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament. Am J Vet Res 2006; 67:529536.

    • Search Google Scholar
    • Export Citation

Effect of cold compression therapy on postoperative pain, swelling, range of motion, and lameness after tibial plateau leveling osteotomy in dogs

Kevin A. Drygas DVM, DACVS1, Scott R. McClure DVM, PhD, DACVS2, Robert L. Goring DVM, DACVS3, Antonio Pozzi DMV, MS, DACVS4, Sheilah A. Robertson BVMS, PhD, DACVA5, and Chong Wang PhD6
View More View Less
  • 1 Affiliated Veterinary Specialists, 275 Corporate Way, Ste 100, Orange Park, FL 32073.
  • | 2 Departments of Veterinary Clinical Sciences and Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.
  • | 3 Affiliated Veterinary Specialists, 275 Corporate Way, Ste 100, Orange Park, FL 32073.
  • | 4 Department of Small Animal Clinical Sciences, Collaborative Orthopaedic and Biomechanics Laboratory, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.
  • | 5 Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.
  • | 6 Department of Statistics, College of Liberal Arts and Sciences, Iowa State University, Ames, IA 50011

Abstract

Objective—To evaluate the effect of cold compression therapy (CCT) on postoperative pain, lameness, range of motion of the stifle joint, and swelling following tibial plateau leveling osteotomy (TPLO) in dogs.

Design—Randomized, blinded, placebo-controlled clinical trial.

Animals—34 client-owned dogs with unilateral deficiency of a cranial cruciate ligament undergoing TPLO.

Procedures—Dogs were assigned to 2 groups. Group 1 (n = 17 dogs) received CCT in the 24-hour period following TPLO. Group 2 (n = 17 dogs) received no CCT. Degree of lameness, range of motion, and circumference of the stifle joint were measured before surgery and 1,14, and 28 days after surgery. A modified composite Glasgow pain scale, visual analogue scale, and pain threshold score were used to evaluate signs of pain before surgery and 1,14, and 28 days after surgery. Logistic regression and linear regression analysis were used to compare the measured variables.

Results—No complications were observed, and all dogs tolerated CCT. Use of CCT resulted in lower values for the visual analogue scale and Glasgow pain scale and lower pain threshold scores; lower lameness scores; less swelling; and an increased range of motion 24 hours after surgery. At 14 days after surgery, there were no significant differences between groups. At 28 days after surgery, too few data sets were available for comparison.

Conclusions and Clinical Relevance—CCT decreased signs of pain, swelling, and lameness and increased stifle joint range of motion in dogs during the first 24 hours after TPLO.

Abstract

Objective—To evaluate the effect of cold compression therapy (CCT) on postoperative pain, lameness, range of motion of the stifle joint, and swelling following tibial plateau leveling osteotomy (TPLO) in dogs.

Design—Randomized, blinded, placebo-controlled clinical trial.

Animals—34 client-owned dogs with unilateral deficiency of a cranial cruciate ligament undergoing TPLO.

Procedures—Dogs were assigned to 2 groups. Group 1 (n = 17 dogs) received CCT in the 24-hour period following TPLO. Group 2 (n = 17 dogs) received no CCT. Degree of lameness, range of motion, and circumference of the stifle joint were measured before surgery and 1,14, and 28 days after surgery. A modified composite Glasgow pain scale, visual analogue scale, and pain threshold score were used to evaluate signs of pain before surgery and 1,14, and 28 days after surgery. Logistic regression and linear regression analysis were used to compare the measured variables.

Results—No complications were observed, and all dogs tolerated CCT. Use of CCT resulted in lower values for the visual analogue scale and Glasgow pain scale and lower pain threshold scores; lower lameness scores; less swelling; and an increased range of motion 24 hours after surgery. At 14 days after surgery, there were no significant differences between groups. At 28 days after surgery, too few data sets were available for comparison.

Conclusions and Clinical Relevance—CCT decreased signs of pain, swelling, and lameness and increased stifle joint range of motion in dogs during the first 24 hours after TPLO.

Contributor Notes

Supported by Cool Systems Incorporated. Cool Systems Incorporated provided the cold compression system used in the study.

Address correspondence to Dr. Drygas (Kevind33@aol.com).