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BACKGROUND: The use of cold therapy to promote rehabilitation after total knee arthroplasty has a certain theoretical basis, but whether cold therapy can reduce bleeding, reduce pain, and promote early recovery of activity is still controversial. OBJECTIVE: To evaluate the effectiveness of cold therapy in total knee arthroplasty in reducing postoperative bleeding, reducing pain, and promoting recovery of motion range using meta-analysis. METHODS: Medline, EMBASE, Cochrane, China Biomedical Literature Database, CNKI, Wanfang and other databases were searched to find randomized controlled trials of cold therapy and other rehabilitation therapies after total knee arthroplasty. Data ware extracted. Statistical analysis was performed using Revman 5.3. Effect values were combined. RESULTS AND CONCLUSION: (1) A total of 10 randomized controlled trials were included, including 1 070 patients. The experimental group received cold therapy after total knee arthroplasty, and the control group received other rehabilitation therapies. (2) Meta-analysis showed that compared with other rehabilitation therapies, cold therapy after replacement alleviated postoperative pain [MD=-0. 75, 95%C/ (-1.29, -0.21 ), P=0.006], reduced hemoglobin drop [MlP-12.11, 95%C/ (-17.66, -6.56), P < 0.000 1]. However, cold therapy could not reduce the amount of opioids usage [MD=0.01, 95%C/ (-0.15, -0.16), P=0.92], or improve joint motion range [MD=6.58, 95%C/ (-0.54, 13. 70), P=0.07]. (3) The results show that the application of cold therapy after total knee arthroplasty can effectively relieve pain and reduce the drop of postoperative hemoglobin, but has no significant effect on reducing the application of opioid analgesics or improving motion range. [ABSTRACT FROM AUTHOR]