Hackensack University Medical Center physicians are now offering ioverao, a handheld device that is applied in the doctor’s office before knee replacement surgery to relieve postoperative knee pain, as well as to reduce the chronic pain of knee osteoarthritis. This cryotherapy treatment has been shown to decrease patients’ use of opioids and restore mobility by reducing stiffness and discomfort.

Knee pain due to osteoarthritis is a very common complaint among adults in the United States. It is a leading cause of disability that impairs quality of life and hinders mobility. Osteoarthritis of the knee is also the number one reason for total knee replacement. “We are continually seeking effective nonsurgical alternatives to opioids to reduce pain in people with chronic knee arthritis and to relieve postoperative pain in those who have had total knee replacement surgery,” explained Gary Panagiotakis, D.O., who specializes in Physical Medicine and Rehabilitation and in Pain Medicine at Hackensack University Medical Center.

The ioverao system is an innovative “cryoneurolysis” approach to blocking pain that relies on the body’s natural response to cold. Here’s how it works:

1. The physician assesses a patient’s pain before the procedure and uses physical examination and ultrasound to identify the nerves responsible for the patient’s knee pain.
2. The nerves are marked and the doctor injects a local anesthetic into the areas to be treated.
3. The ioverao system is a portable handheld device that delivers precise, controlled doses of very cold temperatures to the targeted nerves through a small probe with three tiny needles at its tip. The physician applies the device along each nerve until the nerve is blocked. 
4. The ioverao treatment temporarily stops the nerve from sending pain signals to the brain without damaging surrounding tissue. 
5. Pain relief is immediate and lasts until the nerve regenerates. One treatment with the iovera° system can last 90 days.
6. The treatment areas are cleaned and bandaged, and the patient goes home the same day.

A clinical study showed that patients who received ioverao treatment before total knee replacement surgery requested 45% fewer opioid prescriptions 12 weeks after the operation. They also had less pain two weeks after surgery. Patients with chronic osteoarthritis who received ioverao treatment experienced less stiffness 30 days after the treatment and reported improved physical function at the 90-day mark.

“Traditionally, opioid pain medications have been the first line of defense against knee pain due to osteoarthritis, both before and immediately after surgery, despite causing side effects that can detract from a patient’s recovery,” noted Yair Kissin, M.D., an orthopedic surgeon at Hackensack University Medical Center who specializes in knee replacement. “The iovera° system has provided us with a new approach to enhance the recovery of our patients and improve patient comfort without opioids.”

“Hackensack University Medical Center is committed to ensuring that our patients have access to the latest approaches to relieve pain while reducing the dependence on opioids,” added Michael A. Kelly, M.D., chairman of Orthopedic Surgery. “We are proud to have the ioverao system in our arsenal of tools and look forward to expanding its applications to further enhance the exceptional care we provide to our patients with acute and chronic knee pain.”

About iovera°

The iovera° system is used to destroy tissue during surgical procedures by applying freezing cold. It can also be used to produce lesions in peripheral nervous tissue by the application of cold to the selected site for the blocking of pain. It is also indicated for the relief of pain and symptoms associated with osteoarthritis of the knee for up to 90 days. The iovera° system is not indicated for treatment of central nervous system tissue. It is important to note that iovera° does not treat the underlying cause of pain. Timely remediation is necessary to address and treat the cause of pain. iovera° has been studied in clinical trials of patients prior to total knee arthroplasty and to treat the pain and symptoms of knee osteoarthritis. Additional information is available at www.iovera.com.