After Knee Replacement, Some Patients Still Hurt—Here's a Surprising New Fix

For up to 20% of knee replacement patients, the surgery that was supposed to end their pain becomes the beginning of a new struggle. Despite having a successful total knee arthroplasty (TKA), these patients continue experiencing debilitating pain long after recovery should be complete. When traditional treatments fail and the implant itself isn't the problem, a cutting-edge technique called cryoneurolysis is providing surprising relief by literally freezing away the pain.

What Is Cryoneurolysis and How Does It Work?

Cryoneurolysis, also known as cryoablation, uses an ancient concept with modern precision: controlled freezing to stop pain signals. The procedure targets genicular nerves—the specific sensory nerves that carry pain messages from your knee joint to your brain. Think of these nerves like electrical wires transmitting unwanted pain signals.

During the outpatient procedure, doctors use a specialized probe called a cryoprobe to deliver extremely cold temperatures between -76°F and -112°F directly to the targeted nerves. This carefully controlled freeze temporarily disrupts the nerve's ability to conduct pain signals. The genius lies in the precision: the freezing damages the nerve's internal structure while preserving the outer protective layer, ensuring the nerve can regenerate properly over the following months.

Who Benefits Most from This Freezing Treatment?

Cryoablation isn't suitable for every patient with knee pain after replacement surgery. The treatment works best for people whose pain is "neuropathic," meaning it originates from the nerves rather than mechanical issues with the implant itself. Ideal candidates typically experience specific characteristics:

• Persistent Pain: Chronic knee pain continues months after total knee replacement surgery
• Hardware Clearance: Medical evaluation confirms the knee implant hardware is not causing the pain
• Treatment Resistance: Other non-surgical methods like medication or physical therapy haven't provided adequate relief
• Nerve-Type Pain: Pain feels like burning, tingling, or stabbing sensations rather than dull aching

Before the full procedure, doctors often perform a diagnostic nerve block using temporary anesthetic. If this test injection effectively eliminates the pain, it provides strong evidence that the genicular nerves are the culprit, making the patient an excellent candidate for cryoablation.

What Results Can Patients Expect?

The clinical evidence supporting cryoablation extends far beyond patient testimonials. Multiple research studies demonstrate significant improvements across several key areas. Patients typically experience over 40% reduction in pain levels that lasts for several months. This substantial pain relief enables better participation in physical therapy, leading to improved range of motion and overall functional recovery.

Perhaps most importantly, many patients can reduce or completely eliminate their need for opioid pain medications. This represents a major advantage for those concerned about long-term opioid use and dependency risks. The procedure boasts an excellent safety profile, with the most common side effects being temporary numbness, swelling, or bruising at the injection site.

Recent groundbreaking research from Tarabichi Joint Care has been published as the lead article in the Journal of Orthopedic Experience & Innovation, highlighting an even more advanced approach called Intraoperative CryoNeurolysis. This technique uses controlled freezing during knee replacement surgery itself to target pain-transmitting nerves, potentially preventing chronic post-surgical pain before it starts.

Because the nerve damage from cryoablation is reversible, the procedure can be safely repeated if pain returns, offering a sustainable, non-surgical option for long-term pain management. For the significant minority of patients struggling with persistent pain after knee replacement, cryoablation provides a powerful alternative that can restore the pain-free, active life they hoped to achieve from their original surgery.