Introduction and Aims: Cold therapy is known to reduce pain and swelling after surgical procedures on the knee. We hypothesised that if cold therapy is started earlier, then there would be a reduction in pain and swelling in patients undergoing arthroscopic anterior cruciate ligament [ACL] reconstruction.

Method: We prospectively randomised 40 patients undergoing arthroscopic ACL reconstruction with hamstring autograft, to receive either room temperature [19° C] or cold [4° C] arthroscopy irrigation fluid. Patients were then assessed over the following seven days, with regard to pain [measured on a visual analogue scale], and swelling [measured with limb girth at four points around the knee].

Results: Pain scores were consistently reduced in the cold fluid group compared to the room temperature group throughout the post-operative period, and this difference was significant [p< =0.05] from six hours until seven days post-operatively. At day seven, the swelling measured at 5cm below the joint and 5cm above the joint were significantly lower in the cold group compared with the room temperature group. Drainage from the intra-articular drain was significantly lower in the cold group.

Conclusion: The use of cold irrigation fluid is a simple and safe measure by which pain and swelling (at day 7) can be reduced in the early post-operative period for arthroscopic ACL reconstruction.

Introduction Cold therapy is known to reduce pain and swelling after surgical procedures on the knee. We hypothesised that if cold therapy is started earlier, then there would be a reduction in pain and swelling in patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction

Methods We prospectively randomised 40 patients undergoing arthroscopic ACL reconstruction with hamstring autograft, to receive either room temperature (19°C) or cold (4°C) arthroscopy irrigation fluid.Patients were then assessed over the following 7 days, with regard to pain (measured on a visual analogue scale), and swelling (measured with limb girth at 4 points around the knee).

Results Pain scores were consistently reduced in the cold fluid group compared to the room temperature group throughout the post operative period, and this difference was significant (p< =0.05) from 6 hours until 7 days post-operatively

At day 7 the swelling measured at 5cm below the joint and 5cm above the joint were significantly lower in the cold group compared with the room temperature group.

Drainage from the intra-articular drain was significantly lower in the cold group.

Conclusion The use of cold irrigation fluid is a simple and safe measure by which pain and swelling (at day 7), can be reduced in the early post-operative period for arthroscopic ACL reconstruction.