Cryoneurolysis as a Treatment for Knee Pain Preventing Participation in Inpatient Rehabilitation: A Proof of Concept Prospective Cohort Study
Abstract
Background Knee osteoarthritis and other causes of knee pain can limit participation in inpatient rehabilitation, particularly among older, medically complex patients. Cryoneurolysis may provide sustained, drug-free analgesia by temporarily interrupting sensory nerve conduction while preserving nerve structure. Objective To evaluate the effects of ultrasound-guided cryoneurolysis on knee pain, range of motion, and functional independence in the in-patient setting. Methods This single-centre prospective cohort study included 15 patients with knee pain, diagnosed with arthritis on recent x-rays that interfered with mobility, transfers, or rehabilitation participation. Following a positive diagnostic nerve block, cryoneurolysis targeted the infrapatellar branch of the saphenous nerve and/or anterior femoral cutaneous nerve branches. Outcomes were assessed at baseline and at 1 week, 1 month, and 3 months. Measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee flexion active and passive range of motion, and the motor Functional Independence Measure (FIM). Linear mixed-effects models evaluated changes over time. Results Participants had a median age of 82 years. WOMAC pain, function, and total scores improved significantly at all follow-up points. Passive knee flexion increased by 15.90° at 1 week, 17.69° at 1 month, and 17.40° at 3 months. Active knee flexion increased significantly by 11.30° at final follow-up. Motor FIM scores improved by 11.00 points in 3 months. No immediate or delayed procedure-related adverse events were observed. Conclusion Cryoneurolysis was associated with sustained improvements in pain, knee motion, and functional independence in older rehabilitation inpatients. Larger controlled studies are required to confirm efficacy, durability, and generalizability and determine effects on rehabilitation participation.
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BibTeX
@article{hashemi2026cryoneurolysis,
title = {{Cryoneurolysis as a Treatment for Knee Pain Preventing Participation in Inpatient Rehabilitation: A Proof of Concept Prospective Cohort Study}},
author = {Mahdis Hashemi MD and Fraser MacRae MPT and Paul Winston MD, FRCPC},
journal = {Advances in Rehabilitation Science and Practice},
year = {2026},
month = nov,
doi = {10.1177/27536351261507202},
url = {https://doi.org/10.1177/27536351261507202},
note = {CC BY},
}
RIS
TY - JOUR
TI - Cryoneurolysis as a Treatment for Knee Pain Preventing Participation in Inpatient Rehabilitation: A Proof of Concept Prospective Cohort Study
AU - Mahdis Hashemi MD
AU - Fraser MacRae MPT
AU - Paul Winston MD, FRCPC
PY - 2026
DA - 2026/11/07
JO - Advances in Rehabilitation Science and Practice
DO - 10.1177/27536351261507202
UR - https://doi.org/10.1177/27536351261507202
AB - Background Knee osteoarthritis and other causes of knee pain can limit participation in inpatient rehabilitation, particularly among older, medically complex patients. Cryoneurolysis may provide sustained, drug-free analgesia by temporarily interrupting sensory nerve conduction while preserving nerve structure. Objective To evaluate the effects of ultrasound-guided cryoneurolysis on knee pain, range of motion, and functional independence in the in-patient setting. Methods This single-centre prospective cohort study included 15 patients with knee pain, diagnosed with arthritis on recent x-rays that interfered with mobility, transfers, or rehabilitation participation. Following a positive diagnostic nerve block, cryoneurolysis targeted the infrapatellar branch of the saphenous nerve and/or anterior femoral cutaneous nerve branches. Outcomes were assessed at baseline and at 1 week, 1 month, and 3 months. Measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee flexion active and passive range of motion, and the motor Functional Independence Measure (FIM). Linear mixed-effects models evaluated changes over time. Results Participants had a median age of 82 years. WOMAC pain, function, and total scores improved significantly at all follow-up points. Passive knee flexion increased by 15.90° at 1 week, 17.69° at 1 month, and 17.40° at 3 months. Active knee flexion increased significantly by 11.30° at final follow-up. Motor FIM scores improved by 11.00 points in 3 months. No immediate or delayed procedure-related adverse events were observed. Conclusion Cryoneurolysis was associated with sustained improvements in pain, knee motion, and functional independence in older rehabilitation inpatients. Larger controlled studies are required to confirm efficacy, durability, and generalizability and determine effects on rehabilitation participation.
SN - 2753-6351
ER -