Cryoanalgesia of the ankle joint: clinical cases in the practice of a doctor of interventional pain treatment

Abstract

BACKGROUND: Currently, with the advent of the cryoablation device, much attention is paid to cryoanalgesia of large joints, however, the pathology of smaller structures can also bring discomfort and reduce the patient’s quality of life. The article presents 3 cases of successful treatment of ankle arthrosis at the Multi-Specialty Center for Pain Treatment and Rehabilitation «Anesta» (Arkhangelsk), presenting the author’s method of joint denervation and its detailed description. CLINICAL CASES DESCRIPTION: Three patients were presented. The first with arthrosis of the knee and ankle joint, the second patient — after an accident with purulent-septic complications and violation of the anatomical integrity of the ankle joint, the third — with extensive concomitant pathology and severe arthrosis. All patients were satisfied with the procedure and its impact on the quality of life in the postoperative period. An anatomical rationale and a detailed description of the relevance of the ankle joint cryoanalgesia method are provided. Cryoanalgesia of the ankle joint was tested on cadaver by introducing liquid silicone into the places where the cryoprobe was installed, which confirmed the interest of the sensory branches going to the joint capsule. Due to the fact that the method is proprietary, and the use of cryoanalgesia is limited on the territory of the Russian Federation, there is very little literature data regarding the procedure for performing cryoanalgesia of the ankle joint, however, as experience is gained, we assume that this procedure will become a good alternative to surgery for arthrosis ankle joint. CONCLUSION: The presence of pain has an extremely negative impact on the general condition of patients. The presented author’s technique can significantly improve the quality of life of many patients, minimizing pain in both large and small joints.