Iovera® injection offers opioid-free pain relief after knee replacement

A treatment called iovera® offers hope for patients seeking pain relief without the risk of addiction and side effects associated with opioids.

Orthopaedic surgeon Beau Kildow, MD, says iovera® has been helpful in relieving many of his patients’ knee pain.

“It temporarily freezes the nerves off around your knee, decreasing the pain signal that gets sent back to your brain,” Dr. Kildow says. “It doesn’t work on everyone, unfortunately, but in our practice, there is about a 70% success rate for patients feeling some kind of pain relief.”

iovera® can be used as a standalone outpatient treatment for pain or to improve post-operative pain after knee replacement or similar surgeries. It offers a safe and effective alternative to opioids, which can be addictive and may cause unpleasant side effects.

“Especially in our field of work, where we have to prescribe opioids for our patients for pain control, trying to find other modalities to cut down on that is key,” Dr. Kildow says.

Here’s a deeper dive into what iovera® entails, its benefits and accessibility.

What is iovera®?

• The technology: A handheld device injects liquid nitrogen gas into specific nerves to create a small ice ball under the skin. This stops the nerves from sending pain signals.
• Duration of relief: A 30-minute session can alleviate pain for three to six months.
• Success rate: Dr. Kildow estimates a success rate of about 70% amongst his patients.

Applications of iovera®

• Versatility: While Dr. Kildow has only used iovera® for knee patients, it may also relieve shoulder and ankle pain.
• Limitations: Currently, it is not recommended for back pain relief and may be less effective for hip pain due to anatomical considerations.
• Certification required: Only certified physicians, such as Dr. Kildow and some pain clinic providers, can administer iovera®.

Advantages over opioids

• Reduced side effects: Opioids can cause lowered blood pressure, constipation, drowsiness and dizziness – issues iovera® sidesteps.
• Addiction-free: The iovera® treatment presents a nonaddictive solution to manage post-surgical pain.

Accessibility and insurance coverage

• Medicare coverage: Medicare covers iovera® treatments.
• Insurance variability: It is best to check with your insurance provider, as coverage varies. If iovera® is not covered by your insurance provider, Dr. Kildow says his team can submit appeals under special circumstances.

Ongoing research

Nebraska Medicine experts are studying iovera®'s long-term effects on rehabilitation and strength training, seeking to understand how minimal pain post-surgery can impact recovery times and outcomes.

To learn more about iovera® treatments, make an appointment with our orthopaedic team by calling 800.922.0000.