Iovera
Personalized Orthopedics of the Palm Beaches Uses a Novel Approach to Postsurgical Pain Management
At Personalized Orthopedics, we strive to provide patients with improved recovery after surgery, and offering the latest, unique advances in pain management helps us achieve that goal.
Personalized Orthopedics is one of the few practices in the region to adopt the novel iovera° technology that uses the body's natural response to cold to block the signaling portion of a peripheral nerve, temporarily reducing pain during the critical weeks following surgery. 1
The ioverao treatment is a focused cold therapy. Nothing is injected into the treatment area by the ioverao system; therefore, there are no systemic side effects that are typically experienced with NSAIDs, narcotics, or other medications. Mild localized side effects due to the ioverao treatment have been observed.
As part of this novel approach, health care providers at Personalized Orthopedics are able to deliver a concentrated, focused cold zone through a portable, handheld device. This minimally invasive treatment is safe and causes no damage to surrounding tissues.2 During the simple outpatient procedure, ioverao safely and effectively allows patients with knee pain to leave their physician’s office experiencing less pain than they had when they walked in.
At Personalized Orthopedics, ioverao is being used as a part of an enhanced patient recovery protocol for certain situations.
Remember that you have a say in how your pain is treated before and after total knee arthroplasty (TKA). If you have are considering having TKA surgery, we encourage you to speak with your doctor to learn about how ioverao might be right for you.
To read/learn more about this product and how the procedure works, visit:
Testimonial
"I wanted to let you know about my Iovera experience. My procedure was done approximately seven months ago. The day of the procedure I practically danced out of the office. In fact, I remember asking Bill sometime during the procedure if he was finished because that's how quickly I could feel relief. When I got home I immediately experimented with two things I was unable to do since the surgery. The first was bending the knee completely. But the second was more amazing, I was able to cross my left knee over my right knee for the first time in 12 years without any pain at all (a miracle as far as I was concerned) For me these two things were beyond my expectations. I would recommend to anyone who might be thinking of trying IOVERA to go ahead and give it a try, I think you will be amazed at the results. From the minute Dr. Press told me about it, I was a go. If you have any questions beyond what your doctor told you, you can reach me through their office." Carol B. 3/21/2022
"Firstly thank you for the personal and professional courtesies extended to me during the course and scope of recent knee replacement surgeries and ancillary treatments. I have little doubt that the same personal attention is rendered to each and every patient but being made to feel special is an aspect that is sorely needed in all aspects of patient / practitioner relationships. You both excelled in that respect.As regards the IOVERA procedure, like most non-medical people the topic was one of many in which had little or no working knowledge prior to the introduction prior to surgery. From a common-sense standpoint it makes sense that if some preventative protocol could be undertaken to impact he pain threshold resulting from surgery, it should become a routine inclusion in the overall patient treatment. Prior to undertaking the full procedure I did some research with people I know with first-hand experience. The results of the enquiries were quite off-putting with horror stories about excruciating pain and lingering aftereffects accompanied by massive pain. Two “testimonials” reflected pain requiring medications as far as a year out. Their immediate post op pain was described as totally intolerable. I was prepared for the worse but had been given hope that the IOVERA treatments was everything it was expected to be. I certainly was not disappointed . From the first few minutes regaining conscientiousness to this minute the pain never exceeded a level at which I needed to resort to the OXY prescription written for expected pain control. At nearly four weeks post-op I only resorted t use of one Oxy but that was a consequence of my over achieving personality where I pushed the envelope and experienced nontraditional pain levels .I would heartily recommend to anyone requiring knee replacement surgery to avail themselves of the IOVERA treatment if it is suggested by their medical team. Thank you again for your caring practice. " Michael 3/31/2022
"I am writing this email concerning the above procedure that I received prior to surgery replacing my right knee on April 5, 2022.The above procedure or nerve block was performed prior to my operation. Dr. Martin explained that the procedure would block the nerves in the area of my right knee which would result in less post operation pain in my right knee area which would also result in my having to take less medication. The procedure had no adverse affect on my ability to walk. Subsequent to the surgery, I had pain in my right knee for about a day and a half, which pain was greatly reduced in the ensuing days. I ceased taking oxycodin after 4 days.
In about a week I virtually had no pain in my knee. I spoke to other individuals who had a similar operation who stated that they did not have this procedure and had pain in their knees for a longer period of time.
I am of the belief that the nerve block greatly reduced my pain and for the need to take medication as it pertained to postoperative pain and based upon my experience, I recommend that individuals who are contemplating a knee replacement have this procedure." Alexander S. 4/21/2022
"Having undergone the knee replacement surgery on April 26th, I have come to realize and appreciate the importance of the preparatory iovera treatment you performed on April 6th. In my particular case, the advance and longer-term block of the nerves around the knee provided by this treatment resulted in reduced post-surgery pain. Other than Tylenol in the first 3-4 days, there was no need for any of the prescribed pain medication. Also, think it resulted in an earlier start with meaningful physical therapy. Overall, I just wanted to say thanks to you and Liz for recommending and administering this iovera treatment." Frank S 5/20/2022
Indication
The iovera° system is used to destroy tissue during surgical procedures by applying freezing cold. It can also be used to produce lesions in peripheral nervous tissue by the application of cold to the selected site for the blocking of pain. It is also indicated for the relief of pain and symptoms associated with osteoarthritis of the knee for up to 90 days. The iovera° system is not indicated for treatment of central nervous system tissue. The iovera° system’s “1x90” Smart Tip configuration (indicating one needle which is 90 mm long) can also facilitate target nerve location by conducting electrical nerve stimulation from a separate nerve stimulator.
Important Safety Information
The iovera° system should not be used in people with the following conditions:
- Blood that thickens when patient is exposed to cold (cryoglobulinemia), blood appearing in the urine when patient is exposed to the cold (paroxysmal cold hemoglobinuria), skin rash that appears when patient is exposed to the cold (cold urticaria), narrowing of the blood vessels in the hands and feet when patient is exposed to the cold (Raynaud’s disease), and open and/or infected wounds at or near the treatment site
Patients being treated with the iovera° system (a needle-based therapy) may experience certain reactions, including, but not limited to:
- Bruising, swelling, inflammation and/or redness, local pain and/or tenderness, and altered feeling at the site of application
Proper use of the device as described in the User Guide can help reduce or prevent the following reactions:
- In the area(s) where you were treated: damage to the skin from being exposed to cold or heat, darkening or lightening of the skin, and dimples in the skin
- Outside the area(s) where you were treated: muscles may not work or move normally
- Dasa V, Lensing G, Parsons M, Harris J, Volaufova J, Bliss R. Percutaneous freezing of sensory nerves prior to total knee arthroplasty. Knee. 2016;23(3):523-528.
- Hsu M, Stevenson FF. Wallerian degeneration and recovery of motor nerves after multiple focused cold therapies. Muscle Nerve. 2015;51(2):268-275.
The knee is called a hinge joint, due to how it bends and straightens. The knee is composed of the thigh bone (femur), the shin or lower leg bone (tibia), the fibula, and the patella (kneecap). Also supporting and accompanying the knee joint is several ligaments, including the ACL, PCL, MCL, and LCL. This joint is complex, which makes it very prone to injury. Knee problems happen to be the most common reason why people visit an orthopedic surgeon.
The knee contributes to stability, balance, and mobility. If the knee becomes injured or degenerates, it can be very hard to navigate through your daily life without chronic pain. The knee’s cartilage which acts a shock absorber or cushion between the bones, starts to wear down, which causes painful bone-on-bone friction, making it hard to do everyday activities such as running, walking, and playing sports.
During a total knee replacement, the entire knee joint is replaced with an artificial prosthesis. The end of the femur is replaced with metal, with the tibia lined with a metal tray and plastic, known as polyethylene. Friction Is reduced in the joint, relieving pain and allowing a greater range of motion.
