In the absence of reliable evidence, it is the opinion of the workgroup that either continuous cryotherapy or cold packs can be used following shoulder arthroplasty


There was one randomized control trial (Noyes et al- refer below) comparing continuous cryotherapy versus ice pack in 40 patients that did not demonstrate a significant difference in pain scores, quality of sleep or narcotic use.  This study was a mix of patients who received both anatomic and reverse shoulder arthroplasty and was not exclusive to patients who received shoulder arthroplasty for glenohumeral osteoarthritis.


Strength of Evidence (evidence quality): No reliable evidence

Benefits & Harms:

Uncommon potential harm entails prolonged ice pack exposure leading to skin burn.

Cost Effectiveness/Resource Utilization:

Cold therapy units may not be covered by insurance and may add cost to the patient.


It is feasible for patients to manage post-operative swelling with cold therapy units or ice packs.


Future Research:

More high-quality evidence is needed focusing on the effectiveness of cold therapy units in patients who receive anatomic shoulder arthroplasty for osteoarthritis.


Additional References:

Noyes, M.P., Denard, P.J., Continuous cryotherapy vs ice following total shoulder arthroplasty: a randomized control trial. CryAm J Orthop.  2018;47(6).


The Future of OrthoGuidelines


The OrthoGuidelines Process