The primary aim of the study is to evaluate the effects of two local cryotherapy (ice or cold gas) applications on arthritic knees. Evaluation criteria (before/after treatment): * synovial power-Doppler semi-quantitative score * pain VAS (mm) * cytokine levels in synovial fluid * leukocyte count in synovial fluid
After informed consent, patients suffering from inflammatory rheumatic diseases (rheumatoid arthritis, spondyloarthritis, crystal-induced arthritides) with non-septic arthritides were randomized to receive either local ice (30 minutes twice a day) or cold gas (2 minutes twice a day - pulsed hyperbaric CO2). Local cryotherapy was applied at 9 AM and 17 PM. Skin temperature was monitored Knee power Doppler ultrasonography was performed before cryotherapy (9 AM), just after, 2 min after, 2 hours after, before and after the second cold application (8 hours after the first cold application), then the day after at 9 A.M (24 hours after the first cold application). Synovial fluid was also analysed after join arthrocentesis (just before the first cold application, then 24 hours later, after the last ultrasonographic examination. A corticosteroid injection was performed after the second arthrocentesis when necessary. Power Doppler semi-quantitative scores (0-3) were then blindly assessed by a second trained ultrasonographist at the different times of the study. Pain VAS evolution was also monitored throughout the study. Clinical characteristics of patients were collected at baseline. 20 patients suffering from ankle/wrist arthritides were also included in order to evaluate power Doppler score evolution under cold gas or ice-cryotherapy. 15 patients suffering from knee arthritides were treated by local cold gas. 31 patients suffering from knee arthritides were treated by ice. When both knees were arthritic, contralateral synovial fluid and power Doppler score were used as non-treated controls.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
Centre hospitalier universitaire de Besançon
Besançon, Franche-Comté, France
Power Doppler score change (Naredo's 0-3 semi-quantitative scale)
Semi-quantitative power Doppler score was assessed at baseline, just after, 2 min after, 2 hours after, 8 hours after (just before the second cold application then just after), 24 hours after the first cold application.
Time frame: Baseline, 2 minutes, 2 hours, 8 hours, 24 hours
IL-6 levels in knee synovial fluid change (Multiplex, cytometry)
synovial fluid was analysed at baseline, then 24 hours later (after the last ultrasonographic examination)
Time frame: Baseline, 24 hours
pain VAS change (numeric scale)
pain VAS (mm) was recorded at each ultrasonographic examination
Time frame: Baseline, 2 minutes, 2 hours, 8 hours, 24 hours
synovial fluid leukocyte count change (per mm3)
Time frame: Baseline, 24 hours
IL-1beta, TNF-alpha, IL-17, VEGF level changes in the synovial fluid (Multiplex, cytometry)
Time frame: Baseline, 24 hours
skin temperature change (°C, skin temperature probe in the application area)
Skin temperature will be measured during each ultrasonographic examination
Time frame: Baseline, 2 minutes, 2 hours, 8 hours, 24 hours
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