New Treatment Lowers Knee Replacement Pain

Living with severe osteoarthritis in the knee is like living inside a box that keeps getting smaller and smaller.  As knee pain gets worse, it becomes harder and harder for patients to move.  Each year patients find that they are able to do less than they could the year before. Eventually, they have to decide whether to live with constant pain and increasing limitations or get a knee replacement. 

If you’ve ever talked to someone who has had a knee replacement, you know that having a new knee is great, but getting one can be very painful. If one of the reasons for getting surgery is to avoid pain, the thought of a new source of pain (knee replacement surgery) can be scary. Patients are in pain already. They don’t want more pain, even if it promises to be for a much shorter length of time. Fear of more pain can discourage people from getting a surgery that they desperately need. 

Fortunately, knee replacement surgeries don’t have to be what they so often are: painful and miserable experiences. A new technique has been developed that dramatically reduces the pain of knee replacement surgery and recovery. This technique is known as cryoneurolysis. 

For the nerds among us, “cryo” means “involving or producing extreme cold”. “Neuro” means related to the nerves. “Lysis” means “breaking down cells by destroying their outer membrane.” Cryoneurolysis, is therefore, a procedure that uses extreme cold to kill nerve cells. 

For the super-nerds among us, check out the research: Cryoneurolysis before Total Knee Arthroplasty in Patients With Severe Osteoarthritis for Reduction of Postoperative Pain and Opioid Use in a Single-Center Randomized Controlled Trial – PubMed (nih.gov) 

When a patient has cryoneurolysis several days before knee surgery, an anesthesiologist uses cold to destroy some of the nerves that carry knee pain messages to the brain. These cells grow back, but they grow back slowly. By the time they have grown back, most patients have already had knee replacement surgery, finished most of their rehabilitation and have the end of their recovery period in sight. The entire experience is usually much less painful than it would have been without this procedure. 

When patients have less pain, they don’t need as many pain medications. An extra benefit of cryoneurolysis is that it also helps patients use fewer opioids. This is a real “win” for patients who want to avoid such powerful and potentially risky drugs. 

“For Your Health” Podcast

The downside of cryoneurolysis is that it’s not available in all hospitals. Fortunately, it IS available at RMH. If you are considering knee replacement surgery, check out a podcast by Dr. Jeffrey Ginther, an orthopedic surgeon at RMH who helped pioneer the use of cryoneurolysis in Indiana.