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Surgery: Current Research

ISSN - 2161-1076

Abstract

A Safe and Effective Method to Enhance Rehabilitation Following Total Knee Arthroplasty is Cryoneurolysis

David James*

Total Knee Arthroplasty (TKA) patients often endure considerable amounts of incapacitating pain during the immediate postoperative period, necessitating the administration of narcotics, despite the fact that long-term pain and mobility outcomes are favorable. Infrapatellar saphenous and anterior femoral cutaneous nerves may benefit from percutaneous cryoneurolysis to improve function and rehabilitation following surgery while reducing narcotic intake. To determine the total opioid Morphine Milligramme Equivalents (MME) consumed impatiently and at interval follow-up, a retrospective chart analysis of main TKA patients from 2019 to 2020 who had pre-operative cryoneurolysis was conducted. To evaluate baseline features, demographic and medical comorbidities were compared between cryoneurolysis and age-matched control individuals. STATA 17 Software was used to evaluate patientreported outcomes using the KOOS JR and SF-12 scores as well as functional rehabilitation outcomes including knee Range of Motion (ROM), ambulation distance, and Boston AM-PAC scores. 29 cryoneurolysis patients and 28 age-matched control TKA patients were analysed. The differences between groups were not significant for baseline demographics or surgical technique. Cryoneurolysis patients required less inpatient and outpatient MME overall, and their length of stay was shorter, however this difference was not statistically significant. In comparison to the control, cryoneurolysis patients exhibited statistically significant higher 6-week ROM, 1-year follow-up KOOS JR, and SF-12 mental scores. The rates of complications were identical. By lowering the need for MME, cryoneurolysis is a safe, efficient therapy option to enhance active functional recovery and patient satisfaction following TKA. With no increased risk of infections, deep vein thrombosis, or neurologic problems, patients who received cryoneurolysis had on average fewer MME prescribed during the perioperative period, improved active ROM, and improved patient-reported outcomes.

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