Cryoneurolysis to Treat the Pain and Symptoms of Knee Osteoarthritis

By R. Radnovich, MD, et al. 

Osteoarthritis & Cartilage, Vol. 25, (2017): 47-1256. 

This over-verbose, prospective study involved 180 patients with degenerative arthritis of the knee taken off NSAIDs and supplements, etc. for pain.  Fifty-nine of them were in the sham group, i.e. controls, plus each person had their opposite knee as a control.  On 121 of the patients Iovera cryo was applied to the infrapatellar branch of the saphenous nerve and the other 59 received sham treatment.  Unfortunately, in all aspects of this study it appears that the sham group did about as well as the cryo group indicating a large placebo effect questioning the benefit of the cryo.  Unless this treatment (Iovera) is exceedingly inexpensive- this study, which was funded by the manufacturer of the cryo device (MyoScience), leaves little reason to want to offer this treatment to all but the worst candidate for surgery or NSAID.  NSAIDs are proved to be very effective and supported by a much greater amount of research and clinical experience at lower cost.

Note, this study needs to be repeated by independently-funded researchers.  Also, I think it should include a group of patients on full-strength NSAID plus a placebo group of NSAID takers such that there would be essentially a head-to-head trial of NSAID vs. infrapatellar branch of the saphenous nerve cryoablation.