A Full Guide To Cold Therapy After A Total Knee Replacement Surgery

Nervous as you look forward to your total knee replacement surgery? Many of our customers find Supply Physical Therapy for recovery as they anticipate total knee replacement surgery. In this article, our goal is to compile all of the most helpful thought and advice concerning cold therapy recovery from Total Knee Replacement surgery. Our hope is that this will serve as a one stop shop for your cold therapy recovery from Total Knee Replacement Surgery. 

What Is Total Knee Replacement (TKR) Surgery? 

Total knee replacement (TKR), also known as knee arthroplasty, is a surgical procedure designed to relieve pain and restore function in severely diseased knee joints. It involves the removal of damaged cartilage and bone from the surface of the knee joint and replacing them with artificial components.

Early Signs Of Need For Total Knee Replacement Surgery

Patients who typically benefit from TKR are those suffering from severe osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis. Symptoms such as persistent knee pain, stiffness, and swelling that do not respond to conservative treatments like medication, physical therapy, or lifestyle modifications often lead to the consideration of this surgery.


The surgery usually lasts between one to two hours and is performed under general or spinal anesthesia. The orthopedic surgeon makes an incision at the front of the knee to access the joint. The damaged cartilage and bone are carefully removed and replaced with metal and plastic components that mimic the natural movement of the knee. These prosthetic components are designed to fit precisely, ensuring smooth and pain-free movement post-surgery.

Benefits Of TKR Surgery

TKR significantly improves the quality of life for many patients. It alleviates pain, enhances mobility, and allows individuals to return to their daily activities with greater ease. While the artificial knee joint can last 15 to 20 years, advancements in surgical techniques and materials continue to improve the longevity and outcomes of the procedure.

Pre-Surgery Tips

Although this article primarily focuses on cold therapy after TKR, we also wanted to compile some practical tips for coping with life immediately before and after surgery.

Acquire Essential Assistive Equipment

Before your total knee replacement surgery, it's crucial to have the necessary assistive equipment to ensure a smooth recovery. Walking aids like crutches, a cane, or a walker will help you move around safely as you regain strength. Shoehorns and sock aids make dressing easier, while grab bars installed around your home provide extra support in key areas. Reachers and tongs are helpful for picking up items without bending, and a raised toilet seat can make sitting and standing more comfortable. Additionally, a tub chair is essential for safe and easy bathing.

It is wise to order cold therapy from a trusted brand (like DonJoy or Breg) equipment is vital for managing post-surgery pain and swelling. Ice packs or wraps are great for reducing swelling and alleviating pain around the surgical site. Extra pillows will help you elevate and support your leg when sitting or lying down. Wearing comfortable, loose-fitting shorts or pants is important to avoid irritation or restriction around your incision. These preparations can make your post-surgery experience much more manageable and comfortable.

Pre-Surgical Dietary Guidelines

Its important to prepare for surgery by abiding by the recommended diet. The following guide lines are general suggestions which have been outlined by the authoritative Hospital for Special Surgery (1). But please abide by your doctors instructions rather than these guidelines.

Fourteen Days Prior To Surgery

Fourteen days before your surgery, you'll need to stop all nutritional and herbal supplements, including vitamins and minerals. This includes common supplements like multivitamins, herbal teas, and over-the-counter herbal remedies. These supplements can interfere with your body's normal healing processes and increase the risk of complications. However, you can continue taking calcium, iron, and vitamin D as they are essential for bone health and recovery. Make sure to consult with your doctor if you have any questions about specific supplements.

The Day Before Surgery

The day before surgery, stick to your regular diet. Eating balanced meals will help ensure your body is well-nourished and ready for surgery. Avoid trying new foods or overeating, as this could cause digestive issues. Stay hydrated by drinking plenty of water throughout the day. Following your usual eating patterns will help maintain your energy levels and keep you comfortable.

The Night Before Surgery

The night before, make sure to drink at least 20-24 ounces (about 3 cups) of clear fluids. Clear fluids include water, clear broths, apple juice, and sports drinks. Avoid alcoholic beverages, caffeinated drinks, and anything with dairy. Do not eat any solid food after midnight—only clear fluids are allowed after that point. This helps to ensure your stomach is empty for the anesthesia, reducing the risk of complications during surgery.

The Day Of Surgery

On the day of surgery, you'll need to continue with only clear fluids. Drink at least 12 ounces (1 ½ cups) of clear fluids before you arrive at the hospital. Clear fluids can include water, apple juice, or clear sports drinks. Avoid any colored or carbonated beverages. Following these instructions helps to keep you hydrated without filling your stomach.

Clear Fluid Diet

When following a clear fluid diet, you have a variety of options to keep you hydrated and maintain some energy. Allowed fluids include water, apple, cranberry, and grape juice. You can also have Gatorade, black coffee or tea, and clear broth. Other options are ginger ale and seltzer, Jello, and Italian ice. Chewing gum is allowed as long as you do not swallow it, and Ensure® Pre-Surgery is permissible if instructed by your doctor.

Certain items are not allowed on the clear fluid diet. These include milk or dairy products, even in coffee and tea. Avoid citrus juices, prune juice, and any juices with pulp. Additionally, steer clear of any food or beverage not listed in the "allowed" column. Following these guidelines is essential to ensure your stomach is properly prepared for surgery.

Have Some Trusted Friends On-Call

Set up child or pet care if needed. This will ease your stress and ensure your loved ones are well taken care of during your recovery.

Arrange help with errands since you won't be able to drive for a few weeks after surgery. Ask friends or family in advance to assist with activities like grocery shopping and picking up prescriptions.

Make a meal schedule. Ask friends and family to drop off meals during your recovery or help you prepare meals you can freeze ahead of time.

Request help with chores and other household needs. This could involve asking a neighbor to mow the lawn or having a family member assist with laundry.

Schedule visits with friends and family. Regular visits can provide emotional support and help you stay connected during your recovery.

Prepare Your Home To For Post-Surgery Ease

To ensure a safe recovery environment, start by moving tripping hazards to avoid falls. Items like throw rugs, children’s toys, electrical cords, and general clutter can cause you to trip or slip, so make sure your floors are clear.

Next, clear a walking path around all furniture. You'll likely need a walker, crutches, or assistance from a loved one after surgery. Rearranging your furniture to create pathways that are at least three feet wide will make it easier for you to move around.

Place items you'll need within easy reach to avoid bending down after surgery. Take anything you use regularly out of lower cabinets and store them somewhere accessible without bending your knees. Keeping a grabbing device nearby can also help you pick up items that are low to the ground.

Consider adding safety rails to your bathroom. This will make it safer and easier for you to use the bathroom.

Finally, arrange a one-level living space if possible. Stairs can be difficult to navigate while you’re recovering, so if you live in a multi-level home, try to adjust your living space so you can stay on one level during your recovery.

Post TKR Surgery Tips

Follow Your Physical Therapy Plan Diligently

Physical therapy is crucial for a successful recovery from total knee replacement surgery. Attend all scheduled sessions and practice the prescribed exercises at home. Consistent physical therapy helps improve your range of motion, strengthens your muscles, and promotes healing. Don't skip sessions, as each one builds on the progress from the last. It is also important to consistently use your cold therapy unit (we recommend the DonJoy Clear3) as prescribed by your doctor. This advanced cold therapy device helps reduce swelling and pain, complementing your physical therapy regimen for optimal recovery.

Prioritize Pain Management

Effective pain management is essential for a comfortable recovery. Take prescribed medications as directed and don't hesitate to communicate with your healthcare provider if your pain isn't well-controlled. Using ice packs or cold therapy can also help reduce swelling and alleviate pain. Staying ahead of the pain will make it easier for you to participate in physical therapy and other recovery activities.

Maintain a Healthy Diet

Eating a balanced diet rich in protein, vitamins, and minerals supports the healing process. Foods high in protein, like lean meats, beans, and dairy products, aid in tissue repair and muscle strength. Including fruits, vegetables, and whole grains ensures you get the necessary nutrients to boost your immune system and energy levels. Staying hydrated is equally important for overall recovery.

Use Assistive Devices as Recommended

Assistive devices such as crutches, a walker, or a cane are vital for maintaining mobility and safety during recovery. Follow your surgeon's or physical therapist's recommendations on when and how to use these devices. Proper use helps you avoid unnecessary strain on your new knee and reduces the risk of falls or other injuries.

Monitor Your Progress and Be Patient

Recovery from total knee replacement surgery is a gradual process that varies for each individual. Keep track of your progress by noting improvements in mobility, pain levels, and overall function. Celebrate small milestones to stay motivated. Be patient with yourself, as full recovery can take several months. Avoid pushing yourself too hard and give your body the time it needs to heal properly.

The Role of Cold Therapy in Post-Surgical Recovery

Among TKR surgery rehabilitation methods, a cold therapy machine with a knee pad is among the most commonly recommended by doctors. Most of our customers purchase from us from a doctors recommendation. 

Cold therapy, also known as cryotherapy, involves applying cold to the surgical site using specialized cold therapy machines.

How It Works

These machines circulate cold water through a pad that wraps around your knee. The cold temperature from the pad causes your blood vessels to narrow, which reduces the amount of blood flowing to the area. This helps to minimize swelling and bruising, common issues following knee replacement surgery, by limiting the accumulation of fluid and blood in the knee.

Pain Management

Another significant advantage of cold therapy is pain management. By numbing the nerve endings around the knee, cold therapy decreases the perception of pain, which can be particularly intense in the initial days following surgery. This reduction in pain can also lead to a decreased reliance on opioid painkillers, which have various side effects and potential for addiction. Consequently, patients can achieve a more comfortable recovery with fewer risks associated with medication.

How Long Will I Use Cold Therapy?

The application of cold therapy is typically recommended for the first few weeks post-surgery. It is generally advised to apply cold for 20-30 minutes several times a day. However, it is essential to follow a healthcare provider's specific instructions to avoid complications such as frostbite or skin irritation.

Cold therapy is a critical component of post-TKR surgery care. It helps to control pain and swelling, enhances mobility, and contributes to a smoother, more effective rehabilitation process, ultimately leading to better surgical outcomes and patient satisfaction.

Top Cold Therapy Brands For TKR


Breg is a renowned brand in the field of orthopedic and sports medicine, specializing in innovative cold therapy solutions. With a strong commitment to improving patient outcomes, Breg designs and manufactures advanced cold therapy machines that are widely used for post-surgical recovery and injury management.

One of Breg’s flagship products is the Polar Care Cube, a compact and user-friendly device that delivers consistent and controlled cold therapy. This machine circulates ice-cold water through a pad that can be wrapped around the knee or other affected areas, providing effective pain relief and reducing inflammation. The Polar Care Cube is favored for its simplicity, portability, and reliability, making it a popular choice among patients and healthcare providers alike.

Breg also offers the Polar Care Wave, which combines cold therapy with compression to enhance recovery. This dual-function device helps to further reduce swelling and improve circulation, supporting a faster and more comfortable healing process. The integration of compression with cold therapy sets the Polar Care Wave apart, addressing multiple aspects of post-operative care in one device.

Breg offers the Kodiak which is battery powered and portable. Offering the only battery powered option on the market, Breg ensures your patients can enjoy the benefits of cold therapy from anywhere: on the sidelines or in the backyard. Each battery pack comes with four replaceable AA batteries ready to power 10-14 hours of motorized cold therapy. Proper use requires an insulation barrier between the Intelli-Flo® pad and the patient’s skin.

Lasly, Breg offers the Polar Care Glacier which is meant to balance the needs of the patient and clinician with its size and durability. 


DonJoy is a renowned brand in the field of orthopedic and cold therapy products, known for its high-quality and innovative solutions designed to aid in recovery and pain management. Specializing in cold therapy machines, DonJoy offers products that circulate cold water through a wrap-around pad, providing consistent and controlled cooling to the affected area. This technology is particularly beneficial for post-surgical recovery, such as after total knee replacement surgery, as it helps reduce swelling, pain, and inflammation. DonJoy's cold therapy units are designed for ease of use, ensuring that patients can manage their recovery effectively at home. The brand's commitment to quality and effectiveness has made it a trusted choice among healthcare professionals and patients alike. DonJoy has one unit with two designs: DonJoy Classic3 and DonJoy Clear3.


Aircast is a renowned brand in the field of cold therapy, particularly known for its high-quality cryotherapy products designed to aid in the recovery of various orthopedic surgeries, including total knee replacement (TKR). The brand's innovative cold therapy systems provide efficient and targeted cooling to reduce pain, swelling, and inflammation.

Aircast products, such as the IC Cooler system, combine cold and compression therapies, which are essential for effective post-operative care. The Cryo/Cuff wraps snugly around the knee and connects to a cooler filled with ice water, which circulates through the cuff to deliver consistent, controlled cooling. This design ensures that patients receive continuous cold therapy without the inconvenience of constantly changing ice packs.

The Aircast Gravity Cooler is a standout in the brand's lineup of cold therapy products, particularly because it is the only non-electric model available. Designed for simplicity and effectiveness, the gravity cooler provides targeted cold therapy without the need for electrical power, making it highly versatile and portable.

The ease of use, effectiveness, and comfort provided by Aircast products have made them a preferred choice among healthcare professionals and patients alike. With a focus on promoting healing and improving recovery outcomes, Aircast stands out as a trusted name in the realm of cold therapy.

We hope this article has provided you with valuable insights and practical advice on cold therapy recovery after Total Knee Replacement surgery. By understanding the benefits and proper use of cold therapy, you can enhance your recovery and achieve better surgical outcomes. Remember to consult with your healthcare provider for personalized guidance and to follow their recommendations closely for a successful recovery journey.



(1) A Patient's Guide to Total Joint Replacement Surgery (Hip and Knee). Hospital for Special Surgery. Interdisciplinary Patient Education Committee and the Adult Reconstruction and Joint Replacement Service, Aug 21, 2023.https://www.hss.edu/files/pathway-to-recovery-total-joint-replacement-2023-08-21.pdf.