Starting in November 2021 patients requiring total knee replacement have been getting a pre-op nerve block about 7-10 days pre-op using Iovera, a cryo ablation device that ‘freeze’s nerves in the thigh giving patients significant pain relief for surgery and during their recovery. The cryo lasts 90+ days allowing the patient to avoid narcotics after knee replacement surgery.
Three nerve trunks are targeted by ultrasound for the cryo – the Anterior Femoral Cutaneous Nerve (AFCN), the Lateral Femoral Cutaneous Nerve (LFCN), and the InfraPatellar Branch of the Saphenous Nerve (IPBSN).
Three posterior geniculate nerves are targeted for the radiofrequency (RF) ablation at the same setting and control posterior knee and calf pain for 4-6 months postop.
This procedure is done by a pain management colleague, Devin Peck, MD, in his office and takes 30-45 minutes. Since only sensory nerves are targeted, you walk in and walk out after the procedure – no motor/muscle involvement. No sedation is needed – the procedure is done using local numbing medicine.