A Comparison between Modified Robert Jones Bandage and Intermittent Cold Pack in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Controlled Trial
Chusak Kijkunasathian MD*, Chalermchai Limitlaohaphan MD*, Nadhaporn Saengpetch MD*, Prakasit Chanasit MD*, Petchara Sundarathiti MD**, Patarawan Waratanarat MD, PhD*
Affiliation : * Department of Orthopedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ** Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : Modified Robert Jones bandage and intermittent cold pack are commonly used for postoperative care in
arthroscopic anterior cruciate ligament reconstruction (ACLR). However, no study has been done to compare the postoperative
pain and functional outcome of both methods in ACLR.
Objective : To compare the postoperative pain and functional outcome of a modified Robert Jones bandage and intermittent
cold pack in ACLR.
Material and Method: Forty patients scheduled for ACLR were included. Computer-generated randomization allocated
patients into either modified Robert Jones bandage group (MRJ) or intermittent cold pack group (ICT). Visual analog scale
and morphine usage were assessed postoperatively. Blinded assessors assessed functional outcome, knee swelling, and
patient’s satisfaction.
Results : There were 19 patients in each group. Two groups were well comparable for the prognostic variables. The
postoperative VAS and total morphine usage in both groups were not statistically different. Postoperative knee swelling
increment was significantly lower in ICT than MRJ group (p-value = 0.04). The patient’s satisfaction and positive quadriceps
set test were significantly higher in the ICT group than the MRJ group (p-value <0.01).
Conclusion : Intermittent cold pack has not demonstrated the benefit of pain reduction or morphine usage when compared
to the modified Robert Jones bandage, but it had significantly less knee swelling, a significantly higher patient’s satisfaction
and trend to have better functional outcome. We recommend intermittent cold pack for postoperative care in ACLR.
Keywords : Modified Robert Jones bandage, Cryotherapy, Intermittent cold pack
