What is iovera°?
As a form of cryotherapy, iovera° is often referred to as a way to “freeze away the pain.” Cryotherapy has been in use for thousands of years. Ice has always been a cornerstone of acute pain management, helping to minimize swelling and blocking pain signals to the brain.
Thanks to technological advances, cryotherapy is now able to mitigate pain over longer periods of time, by precisely targeting the nerve that is triggering the pain response. That’s exactly what iovera° does, in a simple, safe, in-office procedure.

What can iovera° be used for?
At Strasburger Orthopaedics, iovera° has already been in use as a pre-operative pain management strategy for knee surgery and knee replacement patients. Before the operation, iovera° can be applied to block the nerves in the knee. The block lasts for several weeks after the surgery until the blocked nerves regenerate, providing long-lasting, safe, and effective pain relief.

With the outbreak of COVID-19, many elective knee surgeries are being postponed. We see patients in pain waiting for their knee replacement, and options are limited. With no clear idea of when normal surgical schedules can be resumed, the question was “how can we minimize ongoing pain?”

The answer was to expand our use of iovera°, and implement it as a bridge treatment to mitigate knee pain for patients who are stuck waiting for a surgery date. With iovera°, knee pain can be relieved without the need to start an opioid medication regimen, or inject the knee with corticosteroids or visco-supplementation that could push back surgery dates. Instead, we can treat your pain now, and then do your knee procedure immediately once a surgical date becomes available.

In addition, as using iovera° as a bridge treatment, we can also provide this therapy as a pain management technique for ongoing knee pain, as an essential medial service. You shouldn’t have to suffer while your ordinary exercise routine is disrupted by COVID-19. With iovera°, your pain can be managed effectively during this crisis.

What is the iovera° procedure like?
As mentioned, we typically use the iovera° treatment just prior to surgery. In the video below, we show how we are also using the technique as a treatment for pain management. First, we use ultrasound imaging to identify the exact nerves sending pain signals to the brain, and mark the skin above and below the knee just over the nerves we are going to treat.

Before we begin treatment, we apply a little lidocaine to numb the area. Then we use a cooling spray before each injection. The iovera° device is primed with CO2. During the injection, three tiny needles penetrate the skin. This feels similar to acupuncture, just a mild pricking or stinging sensation.

Over the next 60 seconds, an ice crystal quickly forms around the nerve. There is usually a sharp tingling sensation that may extend down the nerve. Several more iovera° injections are usually done around each nerve, depending on the patient’s former pain level.