Cryoneurolysis for the Treatment of Knee Arthritis to Facilitate Inpatient Rehabilitation: A Case Report.
Fraser MacRae, Mahdis Hashemi, Ève Boissonnault and 2 others
PMID 39006116WHAT IT FOUND
Less knee pain and faster walking were reported after cryoneurolysis, but she was also receiving rehabilitation, bracing, ankle weights, and earlier IVIG, prednisone, and dexamethasone, so no effect can be attributed.
Key findings
01The patient reported less pain in the treated knee immediately after cryoneurolysis.
02At 7 days, her WOMAC total score was 80 at baseline and 4 at follow-up, and her average 10-meter walk time was 123.31 seconds at baseline and 33.86 seconds at follow-up; higher WOMAC scores mean more knee arthritis impairment.
03She was discharged from inpatient care 13 days after cryoneurolysis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a single case report, so it describes what happened to one person, not whether cryoneurolysis works. She was also receiving rehabilitation, bracing, ankle weights, and earlier IVIG, prednisone, and dexamethasone, so the contribution of cryoneurolysis cannot be separated. There was no comparison group, and the paper reports one patient's outcomes rather than a controlled trial. Follow-up was limited because she lived in a remote community, and the 50-day WOMAC score was 55 after being 4 at 7 days. Her neurologic illness, pneumonia, oxygen need, and rehabilitation progress were also changing around the time of treatment.
Declared interests
The paper does not state funding or conflicts of interest. It names the iovera handheld system made by Pacira as the device used, but it does not say whether the company funded, designed, or wrote the report.
The easy way to misread this
Do not conclude that cryoneurolysis caused her improvement or will help other patients. This was one case, she was also receiving rehabilitation, bracing, ankle weights, and earlier IVIG, prednisone, and dexamethasone, and no comparison group was reported.