Key result
Pre-operative cryoneurolysis consistently reduced post-operative pain scores and decreased opioid consumption by up to 72% in patients undergoing total knee arthroplasty.
Why the study?
Pre-operative cryoneurolysis is an emerging analgesic technique that shows promise in managing post-operative pain and reducing opioid use in patients undergoing total knee arthroplasty.
Does pre-operative cryoneurolysis reduce post-operative pain and opioid use in patients undergoing total knee arthroplasty?
Systematic Review (n=828)
Does pre-operative cryoneurolysis reduce post-operative pain and opioid use in patients undergoing total knee arthroplasty?
Pre-operative cryoneurolysis is a safe and effective adjunct to multimodal pain management in total knee arthroplasty, significantly reducing post-operative pain and opioid consumption.
Supports pre-operative cryoneurolysis in TKA multimodal regimens; extends Level 1 evidence for opioid-sparing adjuncts in orthopedic surgery.
BACKGROUND: Pre-operative cryoneurolysis is an emerging analgesic technique that shows promise in managing post-operative pain and reducing opioid use in patients undergoing total knee arthroplasty (TKA). By inducing targeted Wallerian degeneration of sensory nerves, cryoneurolysis provides prolonged analgesia while preserving motor function, making it a valuable addition to multimodal pain management strategies. METHODS: This systematic review evaluates the efficacy, safety, and clinical utility of cryoneurolysis, synthesizing findings from eight studies, including randomized controlled trials and observational analyses, in adherence to Preferred Reporting Items for Systematic Review and Meta-Analysis 2020 guidelines. Data on pain scores, opioid consumption, functional recovery, and adverse effects were extracted and analyzed to assess clinical outcomes. RESULTS: Cryoneurolysis consistently reduced post-operative pain scores and opioid consumption, with opioid use reductions up to 72%. Enhanced functional recovery, including improved range of motion and quicker rehabilitation milestones, was also observed. The intervention’s safety profile was favorable, with only minimal transient side effects reported and no long-term complications. CONCLUSION: Cryoneurolysis offers significant potential as a cornerstone in multimodal pain management strategies for TKA, particularly in addressing opioid-related public health challenges. While current evidence supports its efficacy, variations in study design and sample sizes necessitate further multicenter trials to establish standardized protocols and optimize its clinical application.
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Pika Krištof Mirt (2025) conducted a systematic review in Total knee arthroplasty (n=828). Pre-operative cryoneurolysis vs. Standard therapy or sham was evaluated on Post-operative pain scores and opioid consumption. Pre-operative cryoneurolysis consistently reduced post-operative pain scores and decreased opioid consumption by up to 72% in patients undergoing total knee arthroplasty.
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