Discussion
Su, pain
RECRUITMENT
The most important outcome from the current study was that patients using the GR cryocompression device over the first two post-operative weeks after TKA demonstrated better knee extension ROM compared with a UC ice and tubigrip protocol. Despite reaching statistical significance, due to the high dropout rate, this finding may be a result of chance. Our findings correlate to those of Ueyama et al. [Previous literature evaluating the GR system have used differing treatment protocols and this may have contributed to the variation in our findings. No previous studies have found any significant improvements in knee ROM. Su et al. [The lack of significant differences between the two groups rejected the study hypothesis. There is an associated cost with use of GR compared to regular icing which must be considered, so although our results show marginal favour towards the use of GR it would be more suited to patients in the private hospital setting. Through the mixed model statistical analysis using gender and age as confounding factors, we discovered that males significantly reported on average less pain on the VAS than females and older patients consumed less opioids. These findings align with previous literature demonstrating a higher prevalence and experience of pain in females [It can be difficult to ascertain if a patient is truly happy and satisfied with the outcome of their TKA. There is a large amount of scope for interpretation of questions posed in PROMs which can lead to variation in results and ultimately may not be the best measurement for patient satisfaction [Several study limitations are acknowledged. Firstly, study onset and recruitment coincided with the onset of the COVID-19 pandemic which impacted data collection due to reduced patient clinic attendance. Losses to follow-up over the 6-week post-operative period could imply that our significant results are due to chance and thus cannot be interpreted as being clinically significant. These circumstances are not unique to our study with the COVID-19 effect on clinical trials being well documented [