KNEE
Iovera is an FDA approved treatment that uses extreme cold to temporarily stop the signals causing pain in the knee. It is best used to help manage pain and increase range of motion after total knee arthroplasty. It is ideal to have the procedure done within 2 weeks of surgery. The procedure is overall simple and well tolerated. Using an ultrasound machine, 4-5 branches of peripheral sensory nerves are identified. Once identified, lidocaine is used to anesthetize the area around the nerve, then a second needle attached to a handheld device is inserted. Once the needle is in the appropriate position, the start button is pressed which begins the process of boiling nitrous oxide forming a gas that travels to the tip of the needle forming a small ice cube also known as the "cold zone." When the frozen needle tip touches the nerve, the sheath of the nerve demyelinates, shutting off the signal to the knee and brain and making the knee feel numb. The numbness is absolutely temporary and will only last for 3-4 months. It will slowly wear off over this period. Following the procedure, band aids are placed over the injection sites. Some bruising or soreness at the injection sites is expected just like any other injection. There are no restrictions after the procedure. Activities may be resumed as tolerated. Patients can still use tylenol or advil, heat or ice. Ninety percent of patients feel better walking out to their car immediately following the procedure. Contraindications to using Iovera include patients with Raynaud's disease or any other allergy or severe reaction to cold. Iovera has been around for over a decade and OrthoRI has had it available for the past 4 years. If you think you would benefit from this procedure for help with post-op pain after total knee arthroplasty, speak with your surgeon or surgical team. Refer to this link for more information.
