Cryoablation: Knocking knee pain out cold

If you’re living with knee pain, a new technology called cryoablation is taking an age-old concept to the next level. 

Ice has long been used to treat pain and discomfort, as coldness reduces nerve activity and helps with swelling. Cryoablation is like putting an ice pack inside the joint rather than on top of it, so people can feel knee pain relief quickly.

Orthopedic specialists at Baylor Scott & White are using the advanced tool to help address pain in people like Jackie Kuhn, a retired nurse, who is living with osteoarthritis in her knees.

While Jackie has arthritis in both knees, she was experiencing debilitating pain in her left knee for about a year before finding cryoablation and a reprieve.

“I could hardly walk. Every time I bent the knee, it really hurt,” she said.

After trying to manage her discomfort with over-the-counter medications and at-home remedies, she was referred for treatment to James King, MD, an orthopedic sports medicine specialist on the medical staff at Baylor Scott & White Medical Center - College Station and Baylor Scott & White Medical Center - Temple.

Cryoablation uses the power of cold to block the nerves from sending pain signals to the brain, relieving the discomfort you can feel in your joints.

During the procedure, a small probe is placed near the nerves in the knee, and the cold temperature temporarily stops them from working, reducing discomfort.

“We feel pain due to the transmission of pain signals from the body to the brain,” Dr. King said. “So, knee pain is transmitted via nerves starting in that spot.”

Who is cryoablation for?

Dr. King and his colleagues have primarily used the technology on people who are experiencing chronic knee pain due to arthritis, and who’ve not had any luck with other conservative treatments. People just like Jackie Kuhn.

“We tried conservative methods, like ice, heat and exercises, and they weren't working,” Jackie said. “So, I tried both the hyaluronic acid visco-supplementation gel injections, and they didn’t work in the left knee—about a week later my knee was still hurting.”

Cryoablation therapy can also be used in people before knee replacement surgery to help manage post-operative pain.

What are the benefits of knee cryoablation?

Studies have shown that people who receive cryoablation for knee arthritis experience less pain for at least 90 days after the treatment. Additionally, they report less stiffness and better physical function.

Meanwhile, research has shown that people receiving cryoablation before knee replacement surgery leave the hospital sooner, experience less discomfort two weeks after their procedure and need fewer prescription medications to manage their pain in the months following surgery.

Additionally, Dr. King points out another advantage of the procedure.

“None of the treatments that we do with cryoablation actually damage any tissue. The nerves will regenerate,” he said.

Once the treatment wears off, those living with knee pain can receive another round. As long as it remains effective, people can continue receiving it indefinitely, which is welcome news for those who are not candidates for, or who do not want, knee replacement surgery.

What can you expect during cryoablation?

Cryoablation is an in-office procedure, which means you won’t need to stay overnight at a hospital.

Dr. King uses test injections of nerve blocks on the knee nerves before performing cryoablation to determine the correct knee nerves to target and check how effective it may be for each person. A nerve block is a type of local anesthesia that temporarily (typically less than 24 hours) blocks pain signals from a nerve.

If the block provides relief, then someone can be scheduled for cryoablation treatment.

“The actual cryoablation procedure is very similar to the test injections,” Dr. King said. Each nerve in the knee is first numbed with an injection. Following the injection, a needle attached to the handheld cryoablation device is inserted near the nerve. Then, liquid nitrogen is sent through to the tip of the needle to freeze it, freezing the surrounding tissue.

“Nothing is actually injected into the patient with the device. It’s just making the tip of the needle really cold—down to -88°F,” Dr. King said.

Despite the needle going to the nerve, there’s generally little to no pain with the procedure; plus, this minimally invasive treatment can provide knee pain relief without affecting other nearby tissues.

“You only feel pressure," Jackie said. "To me, it was basically painless.”

What is cryoablation recovery time like?

Full recovery from cryoablation may take two to four weeks. However, other than avoiding strenuous activity in the days following the procedure, there are no restrictions. People can use ice and over-the-counter pain medications to help with any discomfort or swelling in the knee following the procedure.

Are there side effects with knee cryoablation?

For most people, they can get back to their daily lives very quickly after cryoablation, but there may be some temporary bruising and swelling in treatment areas. In the weeks that follow, sometimes people experience tingling pain or numbness that usually improves over time.

“One of the things I like about cryoablation is that there are no big side effects,” Dr. King said.

Fast results after the freeze

Unlike some knee procedures that may take weeks or months of recovery and rehabilitation, the results of cryoablation are virtually immediate. For those who have been living with knee pain for a long time, the quick relief can be nothing short of amazing.

“The day Dr. King injected it, I just got off that table and was like, ‘Whoa, what happened? Where did the pain go?” Jackie said.

It wasn’t long before she could take walks and even get back on her stationary bike, which she previously enjoyed for exercise.

“I would recommend cryoablation for anybody and everybody.”

The cryoablation procedure is currently offered at Baylor Scott & White Medical Center - College Station, Baylor Scott & White Medical Center - Temple and Baylor Scott & White Medical Center - Waco.

If you’re living with knee pain, take our short assessment and see if it’s time to see an orthopedist who will work with you to move better.