Enhanced Pain Management in Total Knee Arthroplasty: A Retrospective Analysis on Intraoperative Cryo-Neurolysis

Background Cryo-neurolysis has been proposed as an adjunct for postoperative pain management in total knee arthroplasty (TKA) to reduce opioid consumption and enhance functional recovery. However, its long-term efficacy remains underexplored. This study evaluates pain reduction trajectories, opioid use, and mobility outcomes over a six-month period. Methods A retrospective cohort study was conducted on 34 patients who underwent TKA with intraoperative cryo-neurolysis. Pain scores were assessed using the Visual Analog Scale (VAS) at seven time points from postoperative Day 1 to Month 6. Opioid consumption and time to unaided ambulation were recorded. Statistical analyses included the Friedman test for pain trends, the Mann-Whitney U test for group comparisons, and Kaplan-Meier survival analysis for time to pain resolution. Results Median pain scores declined from 2 (Day 1) to 0 (Month 3, p < 0.00001), with all patients achieving complete pain resolution by Month 6. Bilateral procedures demonstrated slightly greater pain reduction at Month 3 (p = 0.048). The median time to VAS = 0 was 90 days (95% CI: 84.2–95.8 days). Opioid use data were inconsistently recorded, limiting conclusive analysis of consumption patterns. No significant associations were found between pain reduction and age, BMI, or comorbidities (p > 0.05). Conclusion Intraoperative cryo-neurolysis significantly reduced postoperative pain and was associated with early pain resolution in TKA patients. These findings suggest it could be a valuable addition to multimodal pain management strategies in TKA. Further randomized trials are warranted to validate these results and assess its impact on opioid use and functional recovery.