Nancy Shultz, 69, is looking forward to getting back out on the golf course.
“I have hope now that I’ll play sooner than I thought I might,” she says.
That’s because Nancy is recovering quicker than she expected. In February, after years of dealing with arthritis in her knees, she underwent a total left knee replacement at OrthoNebraska, the state’s largest and most comprehensive group of orthopaedic subspecialists.
“Before Christmas, I couldn’t straighten my knee. It hurt like the devil to stand and walk on it. I said, ‘This is it.’”
The day after the surgery, Nancy was walking with minimal pain. Her range of motion was good, and she was able to go home.
“When I went into this, I said, ‘Oh no, I won’t be a one-day turnaround. Wrong,” she says. “I went to physical therapy a few days later. The therapist said he was amazed at what I could do.”
Nancy says her recovery, notoriously tough after total knee replacements, has been aided dramatically by something she thinks is “too good to be true,” a pain management tool called Iovera.
“It’s a game-changer,” says Joshua Urban, M.D., a fellowship-trained orthopaedic surgeon at OrthoNebraska, the first facility in the region to perform the FDA-approved treatments. Iovera takes a concept that dates back to ancient Greece – the use of cold to relieve pain – and thoroughly modernizes it.
Using Iovera’s small, handheld device, Dr. Urban is able to immediately alleviate knee pain by knocking out three of the joint’s sensory nerves, temporarily interrupting their ability to send pain signals. Ultrasound pinpoints the nerves, which are then injected and “frozen” by a trio of very small, super-cooled needles. Relief lasts until the nerves regenerate and function returns, a natural process that can take several months. The actual procedure, covered by most health plans, takes 10 to 15 minutes.
OrthoNebraska began using Iovera at the beginning of the year. By the end of February, dozens of patients had opted for the treatment. While it does not address the underlying cause of pain, it does allow patients to enjoy activity pain-free, and after total knee replacements, it has been shown to help patients return home sooner, rehab more quickly and effectively, and cut their use of pain-controlling opioids.
“One study in particular showed that Iovera reduced, by almost half, the narcotic use in total knee patients. That’s a big deal,” Dr. Urban says.
He says OrthoNebraska’s embrace of Iovera stems from its drive to improve the patient experience: “We’re trying to work toward shorter lengths of stay and be a team player for the narcotic problem.”
Despite all the benefits, Dr. Urban says, Iovera is not for everyone: “If you have knee arthritis and you’re getting pain control on one Ibuprofen a day, you don’t need this.”
Side effects, he explains, are similar to any injection: soreness at the injection site for one to two days and potential bruising.
Right now, Iovera is FDA-approved for patients with osteoarthritis and those, like Nancy, who need total knee replacements. She used to be wary of replacing her bad right knee. Not anymore.
“For years, I’ve said I’m holding off until they come up with a better way to do this. Well, I guess they did,” Nancy says.