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Knee

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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_11 | Pages 69 - 69
1 Oct 2019
Mihalko WM Kerkhof A Guyton JL Crockarell JR Harkess JW Ford MC
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Introduction

Even as the outcomes of primary total knee arthroplasty (TKA) continue to improve, there remain increasing concerns about pain control after surgery and prolonged narcotic use. Cryoneurolysis has been demonstrated to reduce osteoarthritis knee pain for up to 90 days. We hypothesized that postoperative narcotic use could be reduced following preoperative cryoneurolysis of the superficial genicular nerves.

Methods

Primary TKA patients were randomized into either a control or cryoneurolysis treatment group. Both followed the same preoperative, intraoperative, and postoperative pain management protocol, except the treatment group had cryoneurolysis of their superficial genicular nerves 3–7 days prior to surgery. All patients were prescribed 40 narcotic pills at discharge and pills were counted at 72 hours and at 2,6, and 12 weeks postoperatively. The primary endpoint was daily morphine equivalent (DME) based on pill count and secondary endpoints were changes in pain and Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, Jr.) scores.