What is iovera○?
iovera○ is a form of targeted cryoanalgesia.
Cryoanalgesia is the use of cold to help treat pain. iovera○ is most commonly used to treat knee pain. In this treatment, cold is applied to a specific nerve. This cold treatment prevents the nerve from sending pain signals.
Who is iovera○ for?
Iovera○ can help to treat knee pain, and pain associated with knee surgery. Your Doctor may use iovera○ treatment either before or after total knee arthroplasty (or total knee replacement). Iovera○ may also be used in other patients with chronic knee pain.
Why is my doctor prescribing iovera○?
Iovera○ can help to decrease the amount of pain experienced after a knee replacement. A US study published in 2021 suggested that patients who undergo a procedure with iovera○ before their knee replacement surgery reported decreased pain and improved function after surgery. Another study published in 2016 suggested that those who underwent a procedure with iovera○ before surgery used less pain medication after their surgery.
What is the procedure for iovera○?
Iovera○ may be applied during a visit to the doctor before your surgery, or immediately before your knee surgery. With both types of procedures, the provider will make markings on your skin. Some of these markings may indicate painful areas. Other markings will identify the location of the nerve.
The clinician will then clean your skin with a substance such as betadine. After cleaning the skin, they will inject a superficial analgesic. This may be similar to getting a Novocain injection at the dentist. This superficial analgesic will help to minimize the amount of discomfort that you experience during the iovera○ procedure.
Once the superficial analgesic takes effect, the clinician will then apply the iovera○ device. The device is applied along the markings made to identify the nerves. The needles of the iovera○ device will pierce your skin, but not inject anything into your body. The clinician will apply the device for 60 seconds in each area. During the procedure, one may feel pressure or a tapping sensation in the treatment area. After using the Iovera device, the clinician will then apply a dressing to your knee.
How does iovera○ work?
The iovera○ device consists of a handheld device with a group of hollow, closed-ended needles attached. The group of needles is referred to as the Smart tip. The Smart tip can have between 1-3 needles. The canister contains nitrous oxide, which is a very cold substance. This substance is not injected into your body. The nitrous oxide moves from the canister in the handheld device into the hollow, closed-ended needle(s). The hollow needle is inserted into your leg and applied to the nerve. Once applied, the nitrous oxide moves into the needle, this creates a cold zone. The cold zone prevents the nerve from sending pain signals, thus helping to decrease your knee pain. Note: there is no opening in the needle, so the nitrous oxide is not injected into your body.
What should I expect after my treatment with iovera○?
One may experience soreness or bruising in the area treated with iovera○ The treatment area may also feel tender or warm. One may also notice slight numbness, or tingling in the area. Keep the treatment area clean and dry. Avoid exercise or strenuous activity for 2-5 days after undergoing iovera○ treatment. Your doctor or healthcare provider can advise you on when to return to your normal activity levels. Your doctor or healthcare provider can also advise you on using ice, or over-the-counter pain medications to help control any soreness experienced after treatment with iovera○.
How long does iovera○ last?
The pain-reliving effects of iovera○ can last for up to 90 days. During that time, your body will heal from the surgery, and the swelling in your knee will decrease. Your doctor or provider may also refer you to physical therapy to help regain the use of your knee. By the time the effects of iovera○ wear off, the issues that were causing pain in your knee (arthritis, and the incision from the surgery) will have resolved. The pain-reliving effects of Iovera can last for up to 90 days.
Since nitrous oxide is very cold, will I get frostbite?
No. The iovera○ device has a skin warmer at the base of the needle. The skin warmer protects your skin from the cold. The cold treatment is only applied to the nerve. You will not get frostbite from this procedure.
Will I still get a prescription for pain medications after my surgery?
Yes, you will still get a prescription for pain medication after surgery. iovera○ can help to decrease the amount of pain you experience after surgery. However, iovera○ alone may not be able to adequately control your pain.
Is iovera○ for everyone?
Those with conditions such as cryoglobulinemia, paroxysmal cold hemoglobinuria, cold urticaria, and Raynaud’s disease may not be appropriate for iovera○ treatment. Treatment with iovera○ should not occur in areas where one has an open and/or infected wound.
Are there complications associated with iovera○?
Complications may include bruising, redness, pain, tenderness, or altered sensation. This should only occur in the area treated with iovera○.
Where can I find more information?
Your doctor or orthopedic provider can give you more information and discuss whether iovera○ is right for you. You may also find more information at: https://www.iovera.com/patient
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