Bulletin of Rehabilitation MedicineBulletin of Rehabilitation MedicineВестник восстановительной медицины2078-19622713-2625National Medical Research Center for Rehabilitation and Balneology69032410.38025/2078-1962-2026-25-2-91-98ArticlesСтатьиReview ArticleLocal cryotherapy after total knee arthroplasty: which method to choose? A literature reviewЛокальная криотерапия после эндопротезирования коленного сустава. Какой способ выбрать? Обзор литературыhttps://orcid.org/0000-0002-5498-3861KazantsevDmitry I.КазанцевДмитрий Игоревич
Russian Federation

Orthopedic Surgeon

врач — травматолог-ортопед

dmitry.kazantsev@inbox.ruhttps://orcid.org/0000-0002-1078-9725OchkurenkoAlexander A.ОчкуренкоАлександр Алексеевич
Russian Federation

D.Sc. (Med.), Professor at the Department of Traumatology and Orthopedics

доктор медицинских наук, профессор кафедры травматологии-ортопедии

dmitry.kazantsev@inbox.ruhttps://orcid.org/0000-0002-2386-4421PeleganchukVladimir A.ПелеганчукВладимир Алексеевич
Russian Federation

D.Sc. (Med.), Chief Physician

доктор медицинских наук, главный врач

dmitry.kazantsev@inbox.ruhttps://orcid.org/0000-0003-0489-1480BatrakYuri M.БатракЮрий Михайлович
Russian Federation

PhD (Med.), Deputy Chief Medical Officer

кандидат медицинских наук, заместитель главного врача по медицинской части

dmitry.kazantsev@inbox.ruFederal Center of Traumatology, Orthopedics and EndoprostheticsФедеральный центр травматологии, ортопедии и эндопротезирования Минздрава РоссииPriorov Central Institute for Trauma and OrthopaedicsНациональный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Приорова Минздрава России2304202625291981209202516032026Copyright ©; 2026, Kazantsev D.I., Ochkurenko A.A., Peleganchuk V.A., Batrak Y.M.Copyright ©; 2026, Казанцев Д.И., Очкуренко А.А., Пелеганчук В.А., Батрак Ю.М.2026Kazantsev D.I., Ochkurenko A.A., Peleganchuk V.A., Batrak Y.M.Казанцев Д.И., Очкуренко А.А., Пелеганчук В.А., Батрак Ю.М.https://creativecommons.org/licenses/by-nc-sa/4.0https://journals.eco-vector.com/2078-1962/article/view/690324

INTRODUCTION. Following total knee arthroplasty, various methods of local cryotherapy are employed ranging from traditional ice packs to specialized temperature-controlled devices. However, despite the wide array of existing cold therapy modalities, the efficacy of local cryotherapy remains controversial due to the heterogeneity of local therapy protocols.

AIM. To identify scientific evidence on local cryotherapy, synthesize findings, and define optimal cryotherapy parameters.

MATERIALS AND METHODS. Literature searches were performed on February 1, 2024 in CyberLeninka, eLibrary.RU, PubMed, and Cochrane databases. Of 664 studies identified, 18 met inclusion criteria. The study period is February – June 2024.

MAIN CONTENT OF THE REVIEW. Evidence-based local cryotherapy after knee arthroplasty requires maintaining skin temperature at 10–15 °C for ≥ 30 minutes, with intra-articular temperature < 30 °C. Early initiation post-surgery and protocol individualization based on cryogen thermophysical properties are critical for efficacy. While advanced cryodevices show promise, current data reveal no conclusive superiority over traditional ice-pack therapy.

CONCLUSION. Standardized cryotherapy protocols remain to be established. Optimizing safety and clinical outcomes necessitates cryogen-specific adjustments of exposure duration/frequency. Implementing temperature-controlled protocols may reduce methodological heterogeneity and improve reproducibility.

ВВЕДЕНИЕ. После тотального эндопротезирования коленного сустава применяются различные методики локальной криотерапии от традиционного использования пакетов со льдом до применения специализированных устройств с контролируемым температурным режимом. Несмотря на широкий спектр существующих способов холодового воздействия, эффективность локальной криотерапии остается противоречивой в связи с гетерогенностью протоколов локальной терапии.

ЦЕЛЬ. Поиск научных доказательств локальной криотерапии, их обобщение и определение оптимальных параметров локальной криотерапии.

МАТЕРИАЛЫ И МЕТОДЫ. Поиск литературы проводился 01.02.2024 в базах данных Киберленинка, eLibrary.RU, PubMed, Cochrane. Согласно стратегии поиска, найдено 664 работы, включено в обзор 18. Период проведения исследования — февраль – июнь 2024 г.

ОСНОВНОЕ СОДЕРЖАНИЕ ОБЗОРА. Научно обоснованная локальная криотерапия коленного сустава после эндопротезирования требует поддержания температуры кожных покровов в диапазоне 10–15 °C в течение 30 минут, при этом внутрисуставная температура должна быть < 30 °C. Ключевыми условиями успеха являются раннее начало локальной криотерапии после оперативного вмешательства и индивидуализация протокола на основе термодинамических характеристик выбранного хладагента. Локальная криотерапия с помощью сложных технических устройств выглядит перспективным способом охлаждения, однако нет убедительных данных за преимущество перед традиционной криотерапией пакетом со льдом.

ЗАКЛЮЧЕНИЕ. Не существует единого протокола локальной криотерапии коленного сустава после эндопротезирования. Для обеспечения безопасности и получения максимального клинического эффекта необходимо осуществлять подбор продолжительности и частоты охлаждения для каждого способа локальной криотерапии. Внедрение стандартизированных протоколов на основе температуроконтролируемого охлаждения мягких тканей позволит снизить гетерогенность методов и повысить воспроизводимость клинических эффектов.

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