Outcome of cryoneurolysis treatment in knee osteoarthritis: A systematic review

To determine the use of Cryoneurolysis for pain reduction, improvement of physical function and quality of life in knee osteoarthritis (KOA), and the safety profile from cryoneurolysis treatment.

This systematic review, conducted in accordance with PRISMA guidelines and registered under PROSPERO ID: CRD42024581457, evaluated the effectiveness, safety, and therapeutic outcomes of cryoneurolysis for KOA from inception to 2 October 2024. A comprehensive search of PubMed, Embase, and CINHAL was conducted. The qualities and risk of potential bias of the studies were appraised using the National Heart, Lung and Blood Institute (NIH) Study Quality Assessment tools.

Five studies (two randomized controlled trials and three non-randomized studies) meet the inclusion criteria. These studies (n = 1064 patients) were found to be of fair to good quality. Findings revealed that cryoneurolysis significantly improved pain relief, functional outcomes (measured by WOMAC and KOOS), and quality of life, with effects lasting up to 6 months. The procedure was well-tolerated overall, with only mild adverse effects reported. However, heterogeneity in study designs, nerve targets, and outcome measures in these five included studies limited the feasibility of meta-analysis, indicating the need for future research on standardizing cryoneurolysis protocols, exploring image-guided techniques, and identifying patient subgroups most likely to benefit.

There are fair to good quality of evidence to suggest cryoneurolysis as a safe and effective treatment for KOA, offering a valuable addition to the current therapeutic arsenal.