Dr. Gary Schwartz
Dr. Gary Schwartz
Oklahoma Surgical Hospital and Advanced Orthopedics of Oklahoma
The surgical and non-surgical staff at Advanced Orthopedics of Oklahoma (AOOK) in conjunction with Oklahoma Surgical Hospital (OSH) worked together to implement an iovera˚ patient protocol for their chronic osteoarthritic pain patients and pre-total knee surgery patients. Listen to the team describe this journey in their own words, including the institutional changes they’re seeing to overall patient outcomes and care.
Integration Champions Sarat Kunapuli, DO, and Christopher Browne, MD
Surgical partners Dr Kunapuli and Dr Browne integrated iovera˚ into their practice at Advanced Orthopedics of Oklahoma (AOOK) to benefit their chronic OA and pre-TKA patient populations. Listen to their challenges and research before introducing iovera˚, their feedback on the treatment itself, and the outcomes they hope to see from continuing treatments into the future.
Clinical Staff Chris Stephens, PA, Rob Ellison, PT, and Julie Keyes, RN
As an in-office procedure, implementation of iovera˚ often means the physician assistants, physical therapists, and nurses are the individuals performing iovera˚ treatments and following up on patients every day. Watch Chris Stephens and Julie Keyes reflect on the effects of iovera treatment on their patients immediately following treatment, as well as Rob Ellison’s point of view as a physical therapist caring for patients through postsurgical rehab.
William Barrett, MD and Jana Flener, PA-C
"When I saw the results of this, I was actually very impressed. It’s fairly dramatic and I think it’s worthwhile to have people see that experience and see what the patient goes through."
William Barrett, MD
"iovera˚ has really changed the way I approach the discussion with the patient as we are talking about what it means to have a knee replacement and how we’re going to manage their pain."
Jana Flener, PA-C
"Instead of having days' worth of pain control, we're now talking about at the very minimum weeks, but more often months. This allows us to provide much better postoperative pain control, allowing people to go through therapy and get through the entire postoperative process in much greater comfort. We were so impressed with the results, it was pretty easy to incorporate into the practice. It was hard to resist the changes that this new approach provided in terms of pain control and better patient outcomes. . . . Try it—really just try it. It really works and you'll be impressed with how well it works."
Sean McMillan, DO
Burlington Township, NJ
"Providing my patients non-surgical options to minimize pain associated with knee OA is huge. The iovera° system allows me to provide pain relief for patients who may not be candidates for knee replacements and are suffering with knee pain. For my TKA patients, iovera° treatment promotes confidence in our opioid-sparing approach prior to the day of surgery. iovera° provides analgesia for postoperative TKA pain and, in my opinion, helps patients get over the ‘pain storm’ quicker during their recovery, without the need for significant opioid consumption."
Scott Sigman, MD
"Evidence continues to mount that patients can undergo a total knee replacement safely and with improved outcomes using an opioid-sparing approach. Our patients are undergoing an iovera° nerve block a week prior to surgery. We then use a long-acting anesthetic at the time of surgery to provide additional pain relief after surgery. In my experience, most of our patients are now going home the day of surgery and are walking independently within 1 week of surgery."
Joshua A. Urban, MD
"The iovera° technology (system) has significantly changed the way I treat patients with chronic or acute knee pain in my practice. It has reduced opioid consumption in these patients after surgery. Treatment with the iovera° system has helped me buy time in my chronic pain patients, and in patients who are not eligible for surgery. I have developed an ultrasound imaging procedure that has helped me better target the nerves that are contributing to my patients’ knee pain."
Pieter Vreede, MD
“We’ve been performing iovera° treatments for several years now and it is one of the few technological advances in anesthesia that addresses a need that, up to now, has not been successfully addressed -orthopedic procedures are at high risk of long-term opioid dependency/abuse. In the knee, iovera° provides long-term (up to 3 months) analgesia along with reduced opioid consumption, better knee flexion at all measured time intervals, and faster recovery. The future for iovera° is extremely bright as we learn how to successfully apply this technology in other surgical procedures.”
Vinod Dasa, MD
New Orleans, Louisiana
“Health care has faced significant disruptions and challenges over the past few years, which were exacerbated by COVID-19 challenges in 2020. As the system resets and finds a new normal, our expectations and demands will change accordingly. What was previously considered theoretical - outpatient opioid-free surgery - is now an expectation for my practice as we develop and deploy new innovations and workflows.”
IndicationThe 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.
Important Safety Information
ContraindicationsThe iovera° system is contraindicated for use in patients with the following:
- Cryoglobulinemia, paroxysmal cold hemoglobinuria, cold urticaria, Raynaud’s disease, and open and/or infected wounds at or near the treatment site
Potential ComplicationsAs with any surgical treatment that uses needle-based therapy and local anesthesia, there is a potential for site-specific reactions, including, but not limited to:
- Ecchymosis, edema, erythema, local pain and/or tenderness, and localized dysesthesia
Proper use of the device as described in the User Guide can help reduce or prevent the following complications:
- At the treatment site(s): injury to the skin related to application of cold or heat, hyper- or hypopigmentation, and skin dimpling
- Outside the treatment site(s): loss of motor function