Preoperative cryoneurolysis in knee OA patients may reduce opioid consumption and improve functional outcomes after TKA
Clinical evidence from patients undergoing TKA indicates that approximately one third of patients still consume opioids 3 months after surgery. The risk of developing persistent postoperative opioid use is evident in patients undergoing TKA who are opioid naive at the time of surgery and is exacerbated in those consuming opioids preoperatively. For this reason, it is critical that orthopedic surgeons balance effective pain management with the minimization of the risk of persistent opioid use.
William M. Mihalko et al found in a study that preoperative cryoneurolysis of the superficial genicular nerves in patients with osteoarthritis would decrease postoperative opioid use relative to standard of care (SOC) treatment in patients undergoing total knee arthroplasty (TKA).The article has been published in “The Journal of Arthroplasty.”
Patients received either cryoneurolysis (intent-to-treat [ITT]: n = 62) or SOC (ITT: n = 62). The cryoneurolysis group received cryoneurolysis of the superficial genicular nerves 3-7 days before surgery plus a similar preoperative, intraoperative, and postoperative pain management protocol as the SOC group. The primary end point was cumulative opioid consumption in total daily morphine equivalents from discharge to the 6-week study follow-up assessment. Secondary end points included changes in pain and functional scores. Primary and secondary end points were assessed using ITT and per-protocol (PP) analyses.
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