Knee replacement has been well known as a painful orthopedic surgery. In fact, many patients who are greatly in need of replacement will often delay surgery because of the anticipated pain of recovery. Knee replacement is physical therapy intensive and the long-term outcome and function of a replaced knee is dependent on the patient’s early progress in therapy. The good news is there is now an option that we can offer our patients to ease the pain of recovery. In a time where opiate use is a hot button topic, we need to look more toward non-opiate options for treating post-operative pain. Such options include non-steroidal anti-inflammatories (NSAIDS, which can be contraindicated for several reasons in some patients), ice, elevation, and now ioverao is an option.
Ioverao is a procedure that can be done in the office five to seven days before surgery, which can help ease the pain during recovery. The ioverao treatment targets two sensory nerves in the knee (the anterior femoral cutaneous nerve and the saphenous nerve) and blocks the nerves from sending pain signals. The pain relieving effect is immediate, and lasts for up to 150 days. Clinical studies that have compared patients treated with ioverao to those not treated and found patients requested fewer narcotic pain medications, have better function, and lower pain scores during recovery. Patients also reported less stiffness when reported at 6 and 12 weeks following surgery.
The procedure takes approximately 20-30 minutes in the office and is generally well tolerated by patients. While there is some discomfort during the procedure, the pain is usually resolved by the end of the treatment. There may be localized bruising or discomfort at the treatment site for 2-3 days following the procedure. No other significant side effects have been noted. Thus far, the results in our office have been encouraging. Clinically, we have seen patients far surpass the expected range of motion goals as early as 2-3 weeks post-op. We have treated patients who had the opposite knee done previously, and they felt that there was a remarkable difference in the recovery when treated with ioverao.