Hackensack University Medical Center Offers Innovative Non-Surgical Treatment For Knee Pain Nerve Freeze Approach Reduces Need For Opioids

Newswise – Doctors at Hackensack University Medical Center now offer ioverao, a handheld device that is applied in the doctor’s office prior to knee replacement surgery to relieve postoperative knee pain, as well as reduce chronic pain from osteoarthritis of the knee . This cryotherapy treatment has been shown to decrease patients’ use of opioids and restore mobility by reducing stiffness and discomfort.

Knee pain due to osteoarthritis is a very common complaint among adults in the United States. It is a major cause of disability that impairs quality of life and hampers mobility. Osteoarthritis of the knee is also the leading cause for total knee replacement. “We are continually looking for effective non-surgical alternatives to opioids to reduce pain in people with chronic knee arthritis and to relieve postoperative pain in those who have had total knee replacement surgery,” explained Gary Panagiotakis, DO, specializing in Physical Medicine and Rehabilitation and Pain Medicine at Hackensack University Medical Center.

The ioverao system is an innovative “cryoneurolysis” approach to blocking pain that relies on the body’s natural response to cold. Here’s how it works:

  1. The doctor assesses a patient’s pain before the procedure and uses a physical exam and ultrasound to identify the nerves responsible for the pain in the patient’s knee.
  2. The nerves are marked and the doctor injects a local anesthetic into the areas to be treated.
  3. The ioverao system is a portable device that delivers precise and controlled doses of very cold temperatures to targeted nerves through a small probe with three small needles at its end. The doctor applies the device along each nerve until the nerve is blocked.
  4. The ioverao treatment temporarily blocks the nerve from sending pain signals to the brain without damaging surrounding tissue.
  5. Pain relief is immediate and lasts until the nerve regenerates. A treatment with the iovera° system can last 90 days.
  6. The treatment areas are cleaned and bandaged, and the patient goes home the same day.

A clinical study showed that patients who received ioverao treatment before total knee replacement surgery requested 45% fewer opioid prescriptions 12 weeks after surgery. They also had less pain two weeks after surgery. Patients with chronic osteoarthritis who received ioverao treatment experienced less stiffness 30 days after treatment and reported improved physical function after 90 days.

“Traditionally, opioid painkillers have been the first line of defense against knee pain due to osteoarthritis, both before and immediately after surgery, despite side effects that can impair a patient’s recovery,” said noted Yair Kissin, MD, an orthopedic surgeon at Hackensack University Medical Center who specializes in knee replacement. “The iovera° system has provided us with a new approach to improving our patients’ recovery and improving patient comfort without opioids.”

“Hackensack University Medical Center is committed to ensuring our patients have access to the latest approaches to pain relief while reducing opioid addiction,” added Michael A. Kelly, MD, Chairman of Orthopedic Surgery. “We are proud to have the ioverao system in our arsenal of tools and look forward to expanding its applications to further enhance the exceptional care we provide to our patients with acute and chronic knee pain.”

About iovera°

The iovera° system is used to destroy tissue during surgery by applying freezing cold. It can also be used to produce lesions in peripheral nerve tissue by applying cold to the selected site for pain blockage. 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 the treatment of tissues of the central nervous system. It is important to note that iovera° does not treat the underlying cause of the pain. Timely remediation is necessary to address and treat the cause of the pain. iovera° has been studied in clinical trials in patients before total knee replacement surgery and to treat the pain and symptoms of osteoarthritis of the knee. Additional information is available at www.iovera.com.


Hackensack University Medical Center, a 781-bed nonprofit teaching and research hospital, was the first hospital in Bergen County founded in 1888. It was also the first hospital in New Jersey and the second in the nation to become a Magnet® Recognized Hospital for Excellence in Nursing, receiving its sixth consecutive designation from the American Nurses Credentialing Center. The academic flagship of the Hackensack Meridian Health network, Hackensack University Medical Center is nationally ranked by US News and World Report 2022-2023 in four specialties, more than any other hospital in New Jersey. The hospital is home to the only nationally ranked urology, neurology, and neurosurgery programs in the state, as well as the top cardiology and cardiac surgery program. It also offers patients nationally ranked orthopedic care and one of the leading cancer centers in the state (John Theurer Cancer Center at Hackensack University Medical Center). Hackensack University Medical Center also ranked among the top performers in conditions such as Acute Kidney Failure, Heart Attack (AMI), Heart Failure, Pneumonia, Chronic Obstructive Pulmonary Disease ( COPD), diabetes and stroke. As well as high performance in procedures such as Aortic Valve Surgery, Cardiac Bypass Surgery (CABG), Colon Cancer Surgery, Lung Cancer Surgery, Prostate Cancer Surgery, Replacement hip and knee replacement. This award-winning care is delivered on a campus that houses facilities such as the Heart & Vascular Hospital; and the Sarkis and Siran Gabrellian Women’s and Children’s Pavilion, home to Donna A. Sanzari Women’s Hospital and Joseph M. Sanzari Children’s Hospital, ranked #1 in the state and top 20 in the region of the mid-Atlantic in the US news and world report‘s 2022-23 Best Children’s Hospital Report. Additionally, the Children’s Nephrology program ranks among the top 50 in the United States. Hackensack University Medical Center is also home to the Deirdre Imus Environmental Health Center and is on the Green Guide’s list of the top 10 green hospitals in the United States. Our comprehensive clinical research portfolio includes studies focused on precision medicine, translational medicine, immunotherapy, cell therapy, and vaccine development. The hospital embarked on the largest health care expansion project ever approved by the state: construction of the Helena Theurer Pavilion, a nine-story, 530,000 square foot building, which began in 2019. A $714.2 million undertaking, the pavilion is one of the largest healthcare capital projects in New Jersey and will house 24 state-of-the-art operating rooms with intraoperative MRI capability, 50 intensive care beds and 175 medical/surgical beds, including a 50-room musculoskeletal institute.


About Antoine L. Cassell

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