Posters
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Academic Level (Author 2)
Medical Student
Academic Level (Author 3)
Medical Student
Academic Level (Author 4)
Medical Student
Academic Level (Author 5)
Faculty
Discipline/Specialty (Author 5)
Orthopedic Surgery
Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Research/Clinical
Abstract
Background: Total knee arthroplasty (TKA) is a highly effective treatment for knee osteoarthritis, but significant postoperative pain often necessitates opioid use. Over 70% of patients use opioid drugs 3 weeks after TKA and up to 15% of TKA patients develop opioid dependence, increasing the risk of adverse effects, infections, and contributes to costly revision surgeries. Cryoneurolysis, a minimally invasive technique involving freezing peripheral nerves, has gained attention as a promising preoperative intervention. This study explores the potential of cryoneurolysis as a preoperative intervention to alleviate pain, reduce opioid dependence, and improve functionality.
Methods: A literature search was conducted using the University of Texas Rio Grande Valley online database and PubMed with keywords including “cryoneurolysis”, “total knee arthroplasty”. Additionally, a semi-structured interview was conducted with a recognized anesthesiologist performing cryoneurolysis.
Results: 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 numerical rating pain scores after TKA between cryoneurolysis treatment groups and control groups throughout the hospital stay and at 2-, 6-, and 12-weeks post TKA. Researchers have demonstrated cryoneurolysis groups were 55% more likely to achieve minimally clinically important difference in pain reduction. Researchers have also found that patients undergoing this procedure consume 68% less total morphine milliequivalents (MME) throughout their hospital stay, 34% fewer opioids at 6 weeks-post-op and 45% fewer morphine equivalents (ME) at 12-weeks post op. Interestingly, one study reported 51% opioid use with cryoneurolysis vs 98% in the control group 6 months post-operatively. Length of stay was also investigated, with reductions observed by an average of 2 days in one study and 44% in a separate study in patients receiving cryoneurolysis as compared to control groups. Lastly, multiple researchers independently identified reductions in Knee Injury and Osteoarthritis Outcome Score (KOOS/KOOS JR) scores which are commonly used to evaluate pain and functionality through a single numerical score.
Conclusion: Numerous studies have demonstrated benefits in managing postoperative pain, increasing functional mobility, and reducing opioid consumption for patients undergoing cryoneurolysis as a preoperative pain management tool. The significant reduction in opioid dependence has the potential to address the ongoing opioid crisis, especially in surgical recovery. Furthermore, as long hospital stays are associated with increased risk of nosocomial infections, the possibility of mitigating the risk through shorter hospitalizations could have system wide implications. Despite these results, larger scale randomized research studies are necessary to confirm the generalizability of this treatment modality; however, its integration into standard preoperative protocols may be hindered if cost reductions are not achieved. Continuous research and prospective improvements in cost-effectiveness and patient satisfaction suggest that cryoneurolysis could emerge as a fundamental element in comprehensive pain management for total knee arthroplasty (TKA).
Recommended Citation
Bonilla, Paul; Murambadoro, Anesu K.; Flanagan, Juan Pablo; Elizondo, Victoria; and Ahmad, Aamir, "Evaluating the Effectiveness of Cryoneurolysis as a Preoperative Intervention in Total Knee Arthroplasty: A literature review" (2025). Research Symposium. 129.
https://scholarworks.utrgv.edu/somrs/2025/posters/129
Evaluating the Effectiveness of Cryoneurolysis as a Preoperative Intervention in Total Knee Arthroplasty: A literature review
Background: Total knee arthroplasty (TKA) is a highly effective treatment for knee osteoarthritis, but significant postoperative pain often necessitates opioid use. Over 70% of patients use opioid drugs 3 weeks after TKA and up to 15% of TKA patients develop opioid dependence, increasing the risk of adverse effects, infections, and contributes to costly revision surgeries. Cryoneurolysis, a minimally invasive technique involving freezing peripheral nerves, has gained attention as a promising preoperative intervention. This study explores the potential of cryoneurolysis as a preoperative intervention to alleviate pain, reduce opioid dependence, and improve functionality.
Methods: A literature search was conducted using the University of Texas Rio Grande Valley online database and PubMed with keywords including “cryoneurolysis”, “total knee arthroplasty”. Additionally, a semi-structured interview was conducted with a recognized anesthesiologist performing cryoneurolysis.
Results: 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 numerical rating pain scores after TKA between cryoneurolysis treatment groups and control groups throughout the hospital stay and at 2-, 6-, and 12-weeks post TKA. Researchers have demonstrated cryoneurolysis groups were 55% more likely to achieve minimally clinically important difference in pain reduction. Researchers have also found that patients undergoing this procedure consume 68% less total morphine milliequivalents (MME) throughout their hospital stay, 34% fewer opioids at 6 weeks-post-op and 45% fewer morphine equivalents (ME) at 12-weeks post op. Interestingly, one study reported 51% opioid use with cryoneurolysis vs 98% in the control group 6 months post-operatively. Length of stay was also investigated, with reductions observed by an average of 2 days in one study and 44% in a separate study in patients receiving cryoneurolysis as compared to control groups. Lastly, multiple researchers independently identified reductions in Knee Injury and Osteoarthritis Outcome Score (KOOS/KOOS JR) scores which are commonly used to evaluate pain and functionality through a single numerical score.
Conclusion: Numerous studies have demonstrated benefits in managing postoperative pain, increasing functional mobility, and reducing opioid consumption for patients undergoing cryoneurolysis as a preoperative pain management tool. The significant reduction in opioid dependence has the potential to address the ongoing opioid crisis, especially in surgical recovery. Furthermore, as long hospital stays are associated with increased risk of nosocomial infections, the possibility of mitigating the risk through shorter hospitalizations could have system wide implications. Despite these results, larger scale randomized research studies are necessary to confirm the generalizability of this treatment modality; however, its integration into standard preoperative protocols may be hindered if cost reductions are not achieved. Continuous research and prospective improvements in cost-effectiveness and patient satisfaction suggest that cryoneurolysis could emerge as a fundamental element in comprehensive pain management for total knee arthroplasty (TKA).
