An open-label, single-arm trial of cryoneurolysis for improvements in pain, activities of daily living and quality of life in patients with symptomatic ankle osteoarthritis

Perry, Thomas A.; Segal, Neil A.

doi:10.1016/j.ocarto.2022.100272

Cited by 5 publications

(10 citation statements)

References 43 publications

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“…There were no long-term pain complaints beyond 3 mos. The early expected symptoms after cryoneurolysis include localized numbness and redness of the skin, swelling, bruising, or pain at the insertion point 14 . Frostbite was not encountered in this study but remains a potential concern if the ice-ball is close to unprotected skin 19 .…”

Section: Discussionmentioning

confidence: 73%

“…The early expected symptoms after cryoneurolysis include localized numbness and redness of the skin, swelling, bruising, or pain at the insertion point. 14 Frostbite was not encountered in this study but remains a potential concern if the ice-ball is close to unprotected skin. 19 A recent study followed 40 patients treated for ankle osteoarthritis with sensory nerve cryoneurolysis using the iovera system.…”

Section: Discussionmentioning

confidence: 82%

“…19 A recent study followed 40 patients treated for ankle osteoarthritis with sensory nerve cryoneurolysis using the iovera system. 14 Twenty-two of 40 participants completed the 24-wk follow-up. There were reported paresthesia in 11% and muscle cramps in 7.5%.…”

Section: Discussionmentioning

confidence: 99%

“…There were reported paresthesia in 11% and muscle cramps in 7.5%. 14 Radnovich et al 13 (2017) treated 121 patients for knee osteoarthritis with cryoneurolysis and had 59 additional patients undergo sham treatment. Ninety percent of adverse events were considered mild.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have documented the safety, adverse effects, and efficacy of cryoneurolysis for pain management in a variety of settings, including for the upper and lower limbs, as well as the head in the case of occipital neuralgia 11–14 . This study will be the first to evaluate the safety and adverse effects of cryoneurolysis used in the treatment of patients with spasticity.…”

mentioning

confidence: 99%

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Analysis of Adverse Effects of Cryoneurolysis for the Treatment of Spasticity

Winston¹,

MacRae

Rajapakshe³

et al. 2023

Am J Phys Med Rehabil

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Objective The aim of the study is to report adverse effects from clinical studies on ultrasound-guided percutaneous cryoneurolysis for spasticity. Design Patients were prospectively enrolled in three studies at a single institution. Cryoneurolysis was performed to primarily motor nerve branches (medial and lateral pectoral, musculocutaneous, radial, median, ulnar, tibial, obturator) and mixed motor sensory nerve trunks (median, ulnar, suprascapular, radial, and tibial). Results Cryoneurolysis was performed for 277 nerves (99 mixed motor sensory), on 113 patients (59 F, 54 M, average age 54.4 yrs). One patient had a local skin infection and two patients had bruising or swelling; all resolved within 1 mo. Nine reported nerve pain or dysesthesia (two motor, seven mixed motor sensory nerves). Four received no treatment, four oral or topical medications, two perineural injections, one botulinum toxin. Three patients’ symptoms remained until 3 mos and one had numbness at six. One patient had botulinum toxin injections for cramping. All had at minimum 3-mo follow-up; seven withdrew (x̄ = 5.4 mos), four passed away. None of these 11 reported adverse effects. Conclusions A total of 96.75% of nerve treatments had no pain or dysesthesias beyond treatment. Few had pain or numbness beyond 3 mos. Cryoneurolysis has potential to be a safe spasticity treatment with manageable adverse effects.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Analysis of Adverse Effects of Cryoneurolysis for the Treatment of Spasticity

Winston¹,

MacRae

Rajapakshe³

et al. 2023

Am J Phys Med Rehabil

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A Narrative Review of Ultrasound-Guided and Landmark-based Percutaneous Cryoneurolysis for the Management of Acute and Chronic Pain

Gabriel,

Seng,

Curran

et al. 2024

Curr Pain Headache Rep

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Purpose of Review Cryoneurolysis refers to the process of reversibly ablating peripheral nerves with extremely cold temperatures to provide analgesia for weeks to months. With ultrasound-guidance or landmark-based techniques, it is an effective modality for managing both acute and chronic pain. In this review, we summarize the reported literature behind its potential applications and efficacy. Recent Findings Here, we summarize several studies (from case reports to clinical trials) describing the use of ultrasound-guided and landmark-based cryoneurolysis for acute and chronic pain. Acute pain indications included pain related to knee arthroplasty, limb amputations, mastectomies, shoulder surgery, rib fractures, and burn. Chronic pain indications included chronic knee pain (due to osteoarthritis), shoulder pain, painful neuropathies, postmastectomy pain syndrome, phantom limb pain, facial pain/headaches, foot/ankle pain, inguinal pain, and sacroiliac joint pain. Summary For both acute and chronic pain indications, more high quality randomized controlled clinical trials are needed to definitively assess the efficacy of cryoneurolysis versus other standard therapies for a multitude of pain conditions.

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