Ice Therapy Machines Experiences/Recommendations?

[Monique]

same with the CPM (continuous passive motion) machine.

It's amazing to me how different protocols are from surgeon to surgeon. I was happy to pay any amount (practically), but my doc was "meh" on the GameReady and saw no need for the passive motion machine. Protocols are SO different that when I called the on-call ortho doc the weekend after my surgery, he wasn't able to answer the "day after operation" question I had because protocols vary!

Paying $75/day is kind of insane. Cold is cold. I'm sure an expensive recirc/cooler might be more consistently colder with no work. The ice/water method if using the cheap gravity system, you just empty and refill after 10 min. Or less. There's your compression release.

I have both the old cryocuff and the new one. The new one is a very small change to the existing system. The cooler needs to be a couple of feet above your knee, which in practice I found to be the biggest challenge. It squeezes and releases every few seconds, which both compressed the joint and forced the water back through the ice to bring in colder water. Obviously, you end up having to reload the ice in the cooler pretty regularly because it's being exposed to water that's gotten warmer. I will don't think there's any difference in the price between the squeeze system and the old one, but it would definitely be worth a couple hundred to me to get the compression effect. I have no idea of its efficacy per se, but it made my knee feel a lot better.

I never used the GameReady, so I can't speak to the differences. But if you were to injure yourself, I would definitely endorse getting the newer version of the Cryocuff cooler, even if you already have the old style.

 

[lisamamot]

my doc was "meh" on the GameReady and saw no need for the passive motion machine.

Go figure. My ACL surgery exposure is with high school and college athletes - unfortunately I know quite a few who have gone through this. The GameReady and the CPM were recommended by each of their surgeons. My daughter was in one machine or the other all day for a handful of days post surgery. They also had her in PT day 2 or 3 post-surgery. Yowza.

@James , luckily my daughter got electric stim as part of her PT so no need to invest in that. At age 17 she got a knee to the side of her knee at speed resulting in a total ACL, partial MCL, strain of the LCL, mild buckling of the PCL, a lateral meniscal tear, a bone dent from the outside of her femur hitting the inside of her tibia, and copious amounts of bone bruising. Who says soccer isn’t a contact sport?! While I wish insurance had helped out, the GameReady rental was worth every penny in helping her recover from patellar tendon ACL reconstruction. Spending an extra couple hundred or so over buying the Cryo machine was decidedly sane.

 

[Monique]

They also had her in PT day 2 or 3 post-surgery. Yowza.

Yeah, my doc actually had me do that, too. Like I said, I'm baffled by the variety of protocols and preferences ortho docs have for ACL surgeries. Makes me think they aren't as well understood as we'd like to hope.

 

[EricG]

Yeah, my doc actually had me do that, too. Like I said, I'm baffled by the variety of protocols and preferences ortho docs have for ACL surgeries. Makes me think they aren't as well understood as we'd like to hope.

It does seem to vary quite a bit. I’m going in for 2nd opinion Friday and curious to see what this doc says. She’s younger than the first guy and I’m hoping she might be a tad more progressive being younger.

 

[Monique]

It does seem to vary quite a bit. I’m going in for 2nd opinion Friday and curious to see what this doc says. She’s younger than the first guy and I’m hoping she might be a tad more progressive being younger.

Might be!

My first visit was to a doc who said I absolutely would not be allowed to ski for 9 months post surgery. I would have to wear a CF brace for at least a year. He didn't ski. The PT I saw at his office said to me, after I told him how important skiing was to me, that "Oh, I would never ski after working here!" This did not seem like a good environment when my stated goal was to get back to skiing as soon as possible.

My second opinion was from a doc recommended by my primary care doc. He said 6 months to gentle groomers, and that braces had pros and cons. I didn't want a brace. He was also a lifelong skier who has had two ACL reconstructions himself. He was a lot older than the first doc.


Did I make the right choice in ortho docs? I don't know. I don't know how these docs determine the success of their protocols, because I've never gotten follow up calls after a year, let alone later, to see how I was doing, and I don't think anyone else does, either. I would have loved a website where I could compare patient satisfaction rates five or ten years post surgery ... any one person's individual circumstances can override the doc's skills, but there should be some sort of meaningful pattern if we had the data.

A friend of mine tore her ACL recently and has been figuring out what route to take. She's having my first doc - the one I didn't choose - do the surgery. We've discussed all the options and the data we can find. It's infuriatingly sparse.

 

[EricG]

@Monique - It’s a gamble no matter who we chose.

My original doc (who I like) is in PC now. Their office mentioned that if I happen to be in town, and happen to get injured & they just happened to have an open surgery spot, they would work something out with the insurance. It’s a very tempting option.

 

[PNWRod]

Hmm...this thread has me thinking. I'd like to be able to do a little ice therapy on my knee during the 90 minute drive home. I'm wondering if a cube would be too much hassle and if it would be better to get a ice pack wrap style.

 

[lisamamot]

Might be!

My first visit was to a doc who said I absolutely would not be allowed to ski for 9 months post surgery. I would have to wear a CF brace for at least a year. He didn't ski. The PT I saw at his office said to me, after I told him how important skiing was to me, that "Oh, I would never ski after working here!" This did not seem like a good environment when my stated goal was to get back to skiing as soon as possible.

My second opinion was from a doc recommended by my primary care doc. He said 6 months to gentle groomers, and that braces had pros and cons. I didn't want a brace. He was also a lifelong skier who has had two ACL reconstructions himself. He was a lot older than the first doc.


Did I make the right choice in ortho docs? I don't know. I don't know how these docs determine the success of their protocols, because I've never gotten follow up calls after a year, let alone later, to see how I was doing, and I don't think anyone else does, either. I would have loved a website where I could compare patient satisfaction rates five or ten years post surgery ... any one person's individual circumstances can override the doc's skills, but there should be some sort of meaningful pattern if we had the data.

A friend of mine tore her ACL recently and has been figuring out what route to take. She's having my first doc - the one I didn't choose - do the surgery. We've discussed all the options and the data we can find. It's infuriatingly sparse.

We met with several surgeons before finding the best fit.

The first surgeon we saw was essentially a "get in as quick as you can" to get an MRI and results; our daughter had been to him previously for a foot injury and it seemed like the best bet to get confirmation. While he is a fine surgeon he specializes in foot and ankle we obviously wanted a knee specialist.

After getting the MRI results we spoke with a doc friend who has had two ACL surgeries himself, who is a long time soccer coach, and whose daughters both play high level soccer to come up with a list of four recommended surgeons.

The first on the list was more local and while an excellent knee surgeon he suggested a different reconstruction method than expected and we wanted another opinion.

The second on the list was in Boston and we felt very lucky to get squeezed in for an immediate appointment; I think the mom stress came over the phone and his assistant said "he doesn't usually see patients this day but he's here and I am putting her on the schedule!". Within minutes of meeting him we knew we didn't need to look any further - his manner, breadth of experience (over 1200 ACL surgeries performed), and dedicated ACL physical therapy team gave us full confidence. His PA does a tremendous amount of data gathering post-surgery; my daughter filled out surveys for the first handful of weeks post-surgery and they continue to follow-up with her.

A specialist surgeon with a tremendous amount of experience coupled with stellar PT and a patient who has an incredible work ethic all combined for a solid recovery.

 

[James]

The best surgeons can have horrible people skills. Ortho probably is a little different since it's carpentry. Hopefully they hook up with good PT people to smooth things out.

 

[Monique]

A specialist surgeon with a tremendous amount of experience coupled with stellar PT and a patient who has an incredible work ethic all combined for a solid recovery.

Presumably, your daughter's youth and (I'm making an assumption here) lack of pre existing medical conditions didn't hurt.

The problem I have is that most patients will never have more than one of these surgeries, and I would imagine no one has as many as 10. So we all think our doc was the best because we really don't have any basis for comparison. We don't know if we, personally, would have done better, or worse, with a different surgeon. Your daughter's results might look very different to those of a 40yo or someone less active or someone with a chronic condition etc- even with the same surgeon. It would only be meaningful if we had standardized forms provided to patients of ALL ortho surgeons, and we had hundreds of data points to get statistically significant outcome information. And that information would need to track patients not just one year out, but five and ten.

 

[lisamamot]

Presumably, your daughter's youth and (I'm making an assumption here) lack of pre existing medical conditions didn't hurt.

The problem I have is that most patients will never have more than one of these surgeries, and I would imagine no one has as many as 10. So we all think our doc was the best because we really don't have any basis for comparison. dWe don't know if we, personally, would have done better, or worse, with a different surgeon. Your daughter's results might look very different to those of a 40yo or someone less active or someone with a chronic condition etc- even with the same surgeon. It would only be meaningful if we had standardized forms provided to patients of ALL ortho surgeons, and we had hundreds of data points to get statistically significant outcome information. And that information would need to track patients not just one year out, but five and ten.

The best personal outcome is what I am interested in and I believe an exceptional surgeon is integral in attaining that. It is certainly not appropriate to try to compare one outcome to another's if they have quite different stats (age, health).

No doubt, her youth and excellent physical shape going into the surgery absolutely benefitted her in her recovery. Unfortunately we know a number of other soccer players her age and in similar physical condition that tore their ACLs as well. Different surgeons, different repair methods, different recovery protocols, and varied outcomes; some excellent, some decidedly not. She could have had her surgery performed at one of many excellent surgeons here, and there are many I would not let touch her knee; we just stopped when we found one that gained our full confidence.

As a whole, yes, I believe the Boston area provides some of the best medical options in the country no matter what the need is and we are grateful to have access to it. Our daughter's ACL surgery is not our first rodeo with medical care here; I was in-patient at Brigham's in Boston for 7 weeks during my precarious pregnancy during which I had a surgery and treatments that allowed us to bring home these now 18 year olds, and our son then had a life threatening brain tumor when he was 4.5 years old and Children's Hospital Boston saved his life. I would like to get off the bucking horse now.

This has gotten quite far off point in regards to the OP's question and I apologize for contributing to that. Medical care is a hot button for me!

 

[Monique]

The best personal outcome is what I am interested in and I believe an exceptional surgeon is integral in attaining that. It is certainly not appropriate to try to compare one outcome to another's if they have quite different stats (age, health).

No doubt, her youth and excellent physical shape going into the surgery absolutely benefitted her in her recovery. Unfortunately we know a number of other soccer players her age and in similar physical condition that tore their ACLs as well. Different surgeons, different repair methods, different recovery protocols, and varied outcomes; some excellent, some decidedly not. She could have had her surgery performed at one of many excellent surgeons here, and there are many I would not let touch her knee; we just stopped when we found one that gained our full confidence.

As a whole, yes, I believe the Boston area provides some of the best medical options in the country no matter what the need is and we are grateful to have access to it. Our daughter's ACL surgery is not our first rodeo with medical care here; I was in-patient at Brigham's in Boston for 7 weeks during my precarious pregnancy during which I had a surgery and treatments that allowed us to bring home these now 18 year olds, and our son then had a life threatening brain tumor when he was 4.5 years old and Children's Hospital Boston saved his life. I would like to get off the bucking horse now.

This has gotten quite far off point in regards to the OP's question and I apologize for contributing to that. Medical care is a hot button for me!

Me, too ;-)

Again, not doubting your surgeon was excellent - I am personally frustrated by the lack of comparative data available for surgical outcomes one year, five years, ten years down the line. I have tried to be a sounding board for my friend who recently tore her ACL, similar age to me, also an engineer with an analytical mind, and it was interesting to see her struggling with the same questions and trying to find data that just doesn't exist.

I have had a lot of difficulties with recovery, which I suspect are due to my own systemic medical issues rather than my surgeon, but it would have been awfully nice to have been able to compare his five year outcomes to the other (terrible bedside manner, but hey, they're surgeons!) doc's before choosing one of them. They've all done thousands of these things - there really ought to be data *grumble*.

Anyhoo, ice machines, I think they're great. Palliative at least. For me, unable to take NSAIDs, constant icing was a godsend.

 

[Lex P]

Here's what I came up with based on my own ideas and input from my orthopedist (who is a skier) and it has worked well, but I will still need surgery. Two days before skiing htake Aleve twice a day and continue until two days after skiing, Really works well on the swelling. Wear a compression sleeve while skiing. When you leave the resort, pack some snow into a plastic bag and ice your knee 20 minutes each hour on your drive home. I then use the ice machine at home This protocol has allowed me to ski 1 to 2 days a week even with a torn meniscus. Give it a try! Using an ice machine on a drive would be, challenging if something goes Blair Witch...

 

[EricG]

Here's what I came up with based on my own ideas and input from my orthopedist (who is a skier) and it has worked well, but I will still need surgery. Two days before skiing htake Aleve twice a day and continue until two days after skiing, Really works well on the swelling. Wear a compression sleeve while skiing. When you leave the resort, pack some snow into a plastic bag and ice your knee 20 minutes each hour on your drive home. I then use the ice machine at home This protocol has allowed me to ski 1 to 2 days a week even with a torn meniscus. Give it a try! Using an ice machine on a drive would be, challenging if something goes Blair Witch...

If you are skiing 2 days a week, that means you are taking Naproxen Sodium 6 days a week, do you have any concerns about the continued usage?

 

[WilWilson]

Hello, I tore my exterior meniscus this fall doing squats to recover from breaking my tibia skiing the previous season (yup). I've been skiing thanks to cortisone shots but with Squaw/Mammoth staying open into July I'm pulling the trigger on a menisectomy next week. Has anybody used one of these cold therapy devices which my doctor recommends? They vary widely in price. Thanks in advance for any insights!

It is recommended that you rent a Polar Products, it is easy to carry, simple to use, and very durable. Overall it is a good cold therapy machine and it is not recommended to buy. Although it is a quiet machine, it actually sounds louder. Moreover, its accuracy is slightly worse than other products.

 

[James]

Haven't read the whole thread. Get this thing. So much easier and better in a car than bags. Ice is available almost everywhere in the US too. You can fill the knee cuff and go drive. Drain it at a stop light or pull over for a minute. Then repeat . So much easier than ice or snow filled bags.
At home you can use the fancy electric unit. Or not.

 

[Kneale Brownson]

Steadman Clinic recommended Game Ready cold therapy machines when both my wife and I had knee surgeries there. Rental was covered by insurance, I believe.

 

[Wilhelmson]

If you're in good standing with an Alma Mater with D1 teams most of them have some high tech ice machines.

 

[mdf]

Get this thing. So much easier and better in a car than bags...At home you can use the fancy electric unit. Or not.
View attachment 85456

I agree with James. That is what I had. Easy and effective. You don't have to empty the whole thing to refresh the coldness -- just open the valve, let the cuff drain into the tank, then raise the tank to refill the cuff.

They aren't really a lifetime investment, though. When I had surgery on my second knee years after the first, the connection where the hose plugs into the cuff leaked and I had to get a new one. (Probably just needed a new o-ring, but I wasn't in the mood to figure it out...)

 

[lisamamot]

If you're in good standing with an Alma Mater with D1 teams most of them have some high tech ice machines.

That is the GameReady - DII schools have it as well.