What Is iovera° Cryoneurolysis?
Peripheral nerves carry pain signals from the knee to the brain. iovera° uses a process called cryoneurolysis, which means using cold to temporarily interrupt a nerve's ability to send signals. The device delivers precise, extreme cold through small needles placed under the skin next to targeted sensory nerves around the knee.
The effect is temporary. According to the manufacturer's labeling, iovera° is indicated for relief of knee osteoarthritis pain for up to 90 days. Because it uses needles, it is a minimally invasive procedure, not a non-invasive one.
At POPB, iovera° is part of our joint replacement program. Dr. Martin, a board-certified orthopedic surgeon with fellowship training in hip and knee reconstruction at Harvard Medical School, works with William Ulrich, PA-C, his physician assistant in the office and the operating room.
Performed in our office with a handheld device, often a few days to weeks before knee replacement.
Who Is a Candidate?
iovera° may be an option for you if:
- You have knee pain from osteoarthritis
- You are scheduled for knee replacement and your surgeon recommends it as part of your recovery plan
- You want to discuss a treatment option that is not a medication
According to the labeling, you should not have iovera° if you have cryoglobulinemia, paroxysmal cold hemoglobinuria, cold urticaria, Raynaud's disease, or an open or infected wound at the treatment site. Tell us about these conditions and any other health concerns before treatment.
What to Expect
Dr. Martin, Dr. Kerr or Mr. Ulrich will first confirm the diagnosis and review your knee X-rays, which can be taken in our office. If you are having knee replacement, iovera° is often scheduled a few days to weeks before surgery.
On the day of treatment, the area around your knee is marked and cleaned. Using the handheld device, your provider places its small needles under the skin along the targeted nerves and applies the cold treatment. The procedure is done in our office, and you go home the same day. Your provider will explain how the skin is prepared and what you may feel during the treatment.
Risks and Side Effects
According to the labeling, common reactions include:
- Bruising
- Swelling
- Redness
- Local pain or tenderness
- Altered sensation, such as numbness or tingling, in the treated area
Your provider will review these and any other risks with you before treatment.
Recovery
Your provider will tell you what activity is appropriate after treatment. Any pain relief is temporary, lasting up to 90 days according to the labeling, and results vary from person to person.
If iovera° is part of your knee replacement plan, it is combined with the rest of your recovery program, including physical therapy. Our physical therapists work in the same office and share your chart with Dr. Martin, so your rehab can be coordinated before and after surgery.
Physical therapy happens in our office, with therapists who share your chart. Learn about on-site physical therapy.
Insurance and Cost
Coverage for iovera° varies by insurance plan. Our team verifies your benefits and explains any out-of-pocket cost before treatment. HMO plans need a referral from your primary care physician before your visit, and co-pays, co-insurance and deductibles are due at the visit.
When to Talk to a Specialist
Call our office if knee arthritis pain limits your walking, sleep or daily activities, or if you are planning knee replacement and want to ask whether iovera° fits your recovery plan.
After any procedure, seek urgent care for fever, spreading redness, warmth or drainage at the treatment site.
