Posters
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Academic Level (Author 2)
Medical Student
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Medical Student
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Medical Student
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Faculty
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Orthopedic Surgery
Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Research/Clinical
Abstract
Background: Total knee arthroplasty (TKA) relieves debilitating knee osteoarthritis but is associated with significant postoperative pain managed by many modalities including opioid treatment. Current pain management strategies rarely address both deep and superficial pain sources effectively. This study aims to introduce a novel dual-modality preoperative pain management technique combining radiofrequency (RF) ablation and cryoneurolysis to improve patient outcomes and reduce opioid dependence postoperatively.
Methods: A literature search was conducted using the University of Texas Rio Grande Valley (UTRGV) online database and PubMed with keywords including “cryoneurolysis” , “TKA” , “radiofrequency ablation”. Additionally, a semi-structured interview was conducted with a recognized anesthesiologist performing cryoneurolysis and radiofrequency ablation as a dual preoperative pain management treatment. A retrospective chart review of de-identified patient compared numerical pain scores between patients undergoing TKA with and without preoperative cryoneurolysis and RFA.
Results: Cryoneurolysis, targeting superficial nerves, offers a promising approach to decreasing acute pain immediately following surgery. Recent studies, including randomized controlled trials and real-world registry analyses, have explored cryoneurolysis as a preoperative intervention, with findings indicating significant reductions in opioid requirements and pain scores after TKA. Studies have highlighted the efficacy of RFA in treating knee osteoarthritis pain, particularly through ultrasound-guided ablation of genicular nerves. Patients treated with RFA have reported significant reduction in pain, as measured by Visual Analog Scale (VAS) scores, and improvements in functional outcomes.
Numerical pain scores (NRS) for cryoneurolysis and radiofrequency ablation at 120 days post-surgery demonstrated a 6-point reduction (8 to 2) compared to a traditional total knee replacement control that demonstrated a 1-point reduction (4 to 3).
Conclusion: The integration of these two individually successful techniques capitalizes on their respective strengths and facilitates an effective postoperative pain management strategy: reduced pain, decreased opioid consumption, and increased range of motion. Large scale studies are needed to confirm validity, ensure generalizability, and confidently draw conclusions on this new approach. The implementation of this dual approach offers significant progress in orthopedics and pain management while addressing the opioid epidemic and rising healthcare costs that come with longer hospital stays and complications.
Recommended Citation
Bonilla, Paul; Flanagan, Juan Pablo; Murambadoro, Anesu Karen; Elizondo, Victoria; Ahmad, Aamir; and Peck, Devin, "Dual-Modality Nerve Ablation: Preoperative Radiofrequency and Cryoneurolysis for Enhanced Pain Relief in Total Knee Arthroplasty" (2025). Research Symposium. 128.
https://scholarworks.utrgv.edu/somrs/2025/posters/128
Included in
Dual-Modality Nerve Ablation: Preoperative Radiofrequency and Cryoneurolysis for Enhanced Pain Relief in Total Knee Arthroplasty
Background: Total knee arthroplasty (TKA) relieves debilitating knee osteoarthritis but is associated with significant postoperative pain managed by many modalities including opioid treatment. Current pain management strategies rarely address both deep and superficial pain sources effectively. This study aims to introduce a novel dual-modality preoperative pain management technique combining radiofrequency (RF) ablation and cryoneurolysis to improve patient outcomes and reduce opioid dependence postoperatively.
Methods: A literature search was conducted using the University of Texas Rio Grande Valley (UTRGV) online database and PubMed with keywords including “cryoneurolysis” , “TKA” , “radiofrequency ablation”. Additionally, a semi-structured interview was conducted with a recognized anesthesiologist performing cryoneurolysis and radiofrequency ablation as a dual preoperative pain management treatment. A retrospective chart review of de-identified patient compared numerical pain scores between patients undergoing TKA with and without preoperative cryoneurolysis and RFA.
Results: Cryoneurolysis, targeting superficial nerves, offers a promising approach to decreasing acute pain immediately following surgery. Recent studies, including randomized controlled trials and real-world registry analyses, have explored cryoneurolysis as a preoperative intervention, with findings indicating significant reductions in opioid requirements and pain scores after TKA. Studies have highlighted the efficacy of RFA in treating knee osteoarthritis pain, particularly through ultrasound-guided ablation of genicular nerves. Patients treated with RFA have reported significant reduction in pain, as measured by Visual Analog Scale (VAS) scores, and improvements in functional outcomes.
Numerical pain scores (NRS) for cryoneurolysis and radiofrequency ablation at 120 days post-surgery demonstrated a 6-point reduction (8 to 2) compared to a traditional total knee replacement control that demonstrated a 1-point reduction (4 to 3).
Conclusion: The integration of these two individually successful techniques capitalizes on their respective strengths and facilitates an effective postoperative pain management strategy: reduced pain, decreased opioid consumption, and increased range of motion. Large scale studies are needed to confirm validity, ensure generalizability, and confidently draw conclusions on this new approach. The implementation of this dual approach offers significant progress in orthopedics and pain management while addressing the opioid epidemic and rising healthcare costs that come with longer hospital stays and complications.
