April 15, 2019
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Cryoneurolysis may relieve knee OA pain, reduce opioid use with TKR

Research has shown mild side effects, no adverse effects with the use of cryoneurolysis in patients with OA.

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ORLANDO — Use of cryoneurolysis among patients with chronic knee pain, such as due to osteoarthritis, may decrease anterior and anteromedial knee pain in the anterior femoral cutaneous nerve, according to a presenter at the Current Concepts in Joint Replacement Winter Meeting.

However, S. David Stulberg, MD, said there is limited information available about the effects of cryoneurolysis on the knee.

A randomized, prospective multicenter study published in Osteoarthritis and Cartilage showed use of cryoneurolysis in patients with mild to moderate OA produced pain relief for up to 6 months, he said.

“What they found was that pain relief anteriorly occurred at 30, 60 and, in some cases, 90 days, and in those patients who had relief as long as 120 days, they often extended to 150 days,” Stulberg said. “So, this technique is thought to provide relief that could last as long as 4 or 5 months.”

S. David Stulberg, MD
S. David Stulberg

The results of the study also showed patients had mild side effects and no adverse device effects, he said.

“[Cryoneurolysis] seems to be safe and even the discomfort that is associated with the application of the device is minimal,” Stulberg said.

Preliminary studies are now being performed using cryoneurolysis before total knee replacement, as well as after TKR in patients with painful TKR, according to Stulberg. He noted that cryoneurolysis is extra-articular, can be applied a few days before surgery and has been shown to be associated with a shorter length of stay.

“It is used in conjunction with current multimodal pain management, so it is not a substitute for what we are already doing, but it is associated with the use of less opioids in the first few weeks following surgery and significant pain reduction,” Stulberg said. – by Casey Tingle

Disclosure: Stulberg reports he receives consulting fees from Consensus Orthopedics, Stryker and Zimmer and receives royalties as a device developer from Innomed.