Cryoanalgesia in the treatment of pain in large joints

Objective. To summarize available data on benefits and safety of cryoanalgesia as a method of treating pain in large joints. Material and methods. We screened PubMed, Cochrane Data base of Systematic Reviews, eLibrary, Google Scholar, Springer Library and National Center for Biotechnology Information (NCBI) databases between 1960-2024 using the following keywords: “cryoanalgesia”, “cryoneurolysis”, “cryoneuroablation”, “knee”, “pain”, “cryoneurolysis”, “shoulder joint”, “hip joint”, “sacroiliac joint”, “multimodal analgesia”, “orthopedic surgery”, “anesthesia”, “postoperative pain”. We found 10 articles devoted to cryoanalgesia of large joints. This review examines pathophysiological features of cryoanalgesia of large joints, as well as application points for this anesthesia. Results. Cryoanalgesia of large joints is attracting attention as a promising alternative to conservative therapy, including opioid therapy. This is especially relevant in recent years due to active consumption of opioids for chronic pain treatment and great number of surgical interventions. Cryoanalgesia has a wide range of therapeutic applications, minimal invasiveness, low risks and small number of contraindications. It partially preserves nerve structure and provides reversible effect. These advantages distinguish cryoanalgesia from other pain management methods. Conclusion. Despite the encouraging results, there are few high-quality randomized controlled trials investigating cryoanalgesia for pain. Nevertheless, available data indicate potentials for this method. Risk of systematic error and clinical heterogeneity of literature data preclude significant quantification of any indicators of effectiveness of cryoanalgesia in the treatment of pain, limit scientific reproducibility and require caution in interpreting the results.