Study to Evaluate the Iovera° Device for Temporary Relief From Knee Pain
Primary Purpose
Knee Osteoarthritis
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
iovera°
Sham Comparator
Sponsored by

About this trial
This is an interventional treatment trial for Knee Osteoarthritis
Eligibility Criteria
Inclusion Criteria:
- 35 - 75 years of age
- American College of Rheumatology (ACR) criteria for osteoarthritis of the knee. This includes radiographic evidence of osteophytes and at least one of the following: age ≥ 50 years old, morning stiffness ≤ 30 minute duration or crepitus on motion.
- Grade II or III osteoarthritis of the knee as determined by Kellgren-Lawrence classification grading scale on anteroposterior (AP) x-ray within previous 6 months.
- Participants are ambulatory without assistive devices.
- Knee pain of ≥ 40 mm on Visual Analog Scale (VAS) when performing one of two movements that elicit the worst pain: standing from a seated position or walking up/down stairs.
- Participant reports knee pain in the anterior and/or inferior aspect of the knee as documented on the knee pain map in the appropriate areas.
- A diagnostic lidocaine (without epinephrine) block of the infrapatellar branch of the saphenous nerve results in a 50% reduction in the VAS pain assessment score when performing the activity that elicits the worst pain: standing from a seated position or walking up/down stairs.
- Participant is able to tolerate a washout of prescription and over-the-counter pain relief for a duration of 5 times the half-life of the medication prior to the Baseline visit.
Participant is able to tolerate a washout of adjunctive therapies for knee pain for 72 hours prior to the Baseline visit.
- Western Ontario and McMaster Osteoarthritis Index (WOMAC) NRS3.1 Pain subscore ≥ 20 at Baseline/Visit 2.
- Participant is able to tolerate discontinuation of all pain medication throughout the duration of the study. Acetaminophen may be used as rescue medication with a maximum dose of 4g per day.
- Participant is able to tolerate discontinuation of rescue medication, acetaminophen, for 24 hours prior to all follow-up visits.
- Prescription and over-the-counter pain medications must be maintained on a stable schedule for at least two weeks prior to screening.
- Participant is willing and able to give written informed consent.
- Participant is willing and able to comply with study instructions and commit to all follow-up visits for the duration of the study.
- Participant is in good general health and free of any systemic disease state or physical condition that might impair evaluation or which in the Investigator's opinion, exposes the Participant to an unacceptable risk by study participation.
Exclusion Criteria:
- History of a partial or full knee replacement of the knee to be treated.
- Planned partial or full knee replacement within the next 12 months in knee to be treated.
- Previous myoscience Focused Cold Therapy^TM (FCTTM) treatment.
- Viscosupplementation within the previous 6 months in knee to be treated.
- Participant reports the majority of knee pain outside of the anterior/inferior aspect of the knee.
- Intra-articular steroid injection in the knee to be treated within previous 3 months.
- Gross deformity of the knee including varus or valgus.
- Started physical therapy of the knee to be treated within 3 months of screening.
- Received acupuncture for knee pain within 3 months prior to screening.
- Body Mass Index ≥ 35.
- Prior surgery in the treatment area that may alter the anatomy of the infrapatellar branch of the saphenous nerve or result in scar tissue in the treatment area.
- Open and/or infected wound in the treatment area.
- Disease of the spine, hip, contralateral knee or other lower extremity joint of sufficient degree affecting the assessment of the treated knee.
- Acetaminophen intolerance or allergy.
- Allergy to lidocaine.
- History of cryoglobulinemia
- History of paroxysmal cold hemoglobinuria.
- History of cold urticaria.
- History of Raynaud's disease.
- History of pes anserinus bursitis in the knee to be treated.
- Use of extended-release or long-acting opioids within previous 3 months.
- Use of immediate-release opioids for more than 3 days per week within previous month.
- Participant is pregnant or planning to become pregnant while enrolled in the study.
- Current enrollment in any investigational drug or device study or participation within 30 days prior to screening.
- Any additional diagnosis that in the opinion of the Investigator directly contributes to knee pain.
- Any concomitant inflammatory disease or other condition that affects the joints (e.g. rheumatoid arthritis, metabolic bone disease, gout, active infection, etc.)
- Any clotting disorder and/or use of an anticoagulant (e.g., aspirin, warfarin, clopidogrel, etc.) within seven (7) days prior to administration of the device.
- Any local skin condition at the treatment site that in the Investigator's opinion would adversely affect treatment or outcomes.
- Any chronic medical condition that in the Investigator's opinion would prevent adequate participation.
- Any chronic medication use (prescription, over-the-counter, etc.) that in the Investigator's opinion would affect study participation or Subject safety.
- For any reason, in the opinion of the Investigator, the Subject may not be a suitable candidate for study participation (i.e., history of noncompliance, drug dependency, any related knee injury due to a worker's compensation claim, etc.).
- Known liver dysfunction.
Sites / Locations
- Medvin Clinical Research
- UC Davis Center for Musculoskeletal Health
- Coastal Orthopedics and Sports Medicine of Southwest Florida, PA
- Shrock Orthpedic Research
- Health Awareness
- JM Clinical Research
- Injury Care Medical Center
- Rockford Orthopedic Associates, LTD
- Kansas University Medical Center
- Kansas City Bone and Joint Clinic
- Covington Orthopedic and Sports Medicine Institute
- LHU HSC Department of Orthopaedics
- Arthritis Treatment Center
- Triangle Orthopaedic Associates, P.A.
- Blair Orthopedic Associates, Inc.
- PCET Research Center
- Spokane Joint Replacement Center
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Sham Comparator
Arm Label
iovera° Treatment
Sham Treatment
Arm Description
Treatment with the iovera° device administered by a trained investigator to treat knee pain.
Sham Treatment (similar device with no active therapeutic treatment) administered by a trained investigator to treat knee pain.
Outcomes
Primary Outcome Measures
Absolute Change From Baseline in Western Ontario and McMaster Universities Arthritis Index (WOMAC) Pain Subscale Score at Day 30
The WOMAC is a tri-dimensional, disease-specific, patient-reported outcome measure. It consists of 24 questions [each question is presented in a numerical rating scale format with possible values between 0= No (best) to 10= Extreme (worst)] with 5 questions regarding pain [possible subscale score 0 to 50], 2 questions regarding stiffness [possible subscale score 0 to 20] and 17 questions regarding function difficulty [possible subscale score 0 to 170]. A negative change from Baseline indicates improvement. An Analysis of Covariance (ANCOVA) model was used for analyses.
Secondary Outcome Measures
Change From Baseline in Visual Analog Scale (VAS) at Day 30
VAS pain assessment is a measure of pain intensity. The scale is made up of a 10 centimeter (cm) [100 millimeter (mm)] horizontal line. The far left of the horizontal line is labeled "no pain" while the far right of the horizontal line is labeled "worst imaginable pain". A negative change from Baseline indicates improvement. An ANCOVA model was used for analyses.
Change From Baseline in Total WOMAC Score at Day 30
The WOMAC is a tri-dimensional, disease-specific, patient-reported outcome measure. It consists of 24 questions [each question is presented in a numerical rating scale format with possible values between 0= No (best) to 10= Extreme (worst)] with 5 questions regarding pain [possible subscale score 0 to 50], 2 questions regarding stiffness [possible subscale score 0 to 20] and 17 questions regarding function difficulty [possible subscale score 0 to 170]. The WOMAC total score was calculated by summing the 3 subscales for a total possible score of 0 to 240. A negative change from Baseline indicates improvement. An ANCOVA model was used for analyses.
Change From Baseline in VAS at Day 60
VAS pain assessment is a measure of pain intensity. The scale is made up of a 10 cm (100 mm) horizontal line. The far left of the horizontal line is labeled "no pain" while the far right of the horizontal line is labeled "worst imaginable pain". A negative change from Baseline indicates improvement. An ANCOVA model was used for analyses.
WOMAC Pain Score Responder Rate at Day 30
WOMAC Pain Score Responder Rate is defined as the percentage of participants with at least a 30% reduction in the WOMAC pain score at Day 30 compared to Baseline. WOMAC is a tri-dimensional, disease-specific, patient-reported outcome measure. It consists of 24 questions [each question is presented in a numerical rating scale format with possible values between 0= No to 10= Extreme] with the first 5 questions regarding pain [possible subscale score 0 (best) to 50 (worst)].
VAS Responder Rate at Day 30
VAS Responder Rate is defined as the percentage of participants with at least a 30% reduction in VAS at Day 30 compared to Baseline VAS pain assessment is a measure of pain intensity. The scale is made up of a 10 cm (100 mm) horizontal line. The far left of the horizontal line is labeled "no pain" while the far right of the horizontal line is labeled "worst imaginable pain".
Change From Baseline in Total WOMAC Score at Day 60
The WOMAC is a tri-dimensional, disease-specific, patient-reported outcome measure. It consists of 24 questions [each question is presented in a numerical rating scale format with possible values between 0= No (best) to 10= Extreme (worst)] with 5 questions regarding pain [possible subscale score 0 to 50], 2 questions regarding stiffness [possible subscale score 0 to 20] and 17 questions regarding function difficulty [possible subscale score 0 to 170]. The WOMAC total score was calculated by summing the 3 subscales for a total possible score of 0 to 240. A negative change from Baseline indicates improvement.
VAS Responder Rate at Day 60
VAS Responder Rate is defined as the percentage of participants with at least a 30% reduction in VAS at Day 60 compared to Baseline. VAS pain assessment is a measure of pain intensity. The scale is made up of a 10 cm (100 mm) horizontal line. The far left of the horizontal line is labeled "no pain" while the far right of the horizontal line is labeled "worst imaginable pain".
WOMAC Pain Score Responder Rate at Day 60
WOMAC Pain Score Responder Rate is defined as the percentage of participants with at least a 30% reduction in the WOMAC pain score at Day 60 compared to Baseline. WOMAC is a tri-dimensional, disease-specific, patient-reported outcome measure. It consists of 24 questions [each question is presented in a numerical rating scale format with possible values between 0= No (best) to 10= Extreme (worst)] with the first 5 questions regarding pain [possible subscale score 0 to 50].
Full Information
NCT ID
NCT02260921
First Posted
October 3, 2014
Last Updated
January 19, 2021
Sponsor
Pacira CryoTech, Inc., a wholly owned subsidiary of Pacira BioSciences, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT02260921
Brief Title
Study to Evaluate the Iovera° Device for Temporary Relief From Knee Pain
Official Title
A Multi-Center, Prospective, Double-Blind, Randomized Controlled Study to Evaluate the Effectiveness and Safety of the Iovera° Device for the Temporary Relief of Pain Associated With Knee Osteoarthritis
Study Type
Interventional
2. Study Status
Record Verification Date
January 2021
Overall Recruitment Status
Completed
Study Start Date
October 20, 2014 (Actual)
Primary Completion Date
February 2016 (Actual)
Study Completion Date
May 31, 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pacira CryoTech, Inc., a wholly owned subsidiary of Pacira BioSciences, Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
No
5. Study Description
Brief Summary
This purpose of this study is to evaluate the effectiveness and safety of the iovera° device for the temporary reduction of pain associated with knee osteoarthritis.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
180 (Actual)
8. Arms, Groups, and Interventions
Arm Title
iovera° Treatment
Arm Type
Experimental
Arm Description
Treatment with the iovera° device administered by a trained investigator to treat knee pain.
Arm Title
Sham Treatment
Arm Type
Sham Comparator
Arm Description
Sham Treatment (similar device with no active therapeutic treatment) administered by a trained investigator to treat knee pain.
Intervention Type
Device
Intervention Name(s)
iovera°
Intervention Type
Device
Intervention Name(s)
Sham Comparator
Primary Outcome Measure Information:
Title
Absolute Change From Baseline in Western Ontario and McMaster Universities Arthritis Index (WOMAC) Pain Subscale Score at Day 30
Description
The WOMAC is a tri-dimensional, disease-specific, patient-reported outcome measure. It consists of 24 questions [each question is presented in a numerical rating scale format with possible values between 0= No (best) to 10= Extreme (worst)] with 5 questions regarding pain [possible subscale score 0 to 50], 2 questions regarding stiffness [possible subscale score 0 to 20] and 17 questions regarding function difficulty [possible subscale score 0 to 170]. A negative change from Baseline indicates improvement. An Analysis of Covariance (ANCOVA) model was used for analyses.
Time Frame
Baseline to Day 30
Secondary Outcome Measure Information:
Title
Change From Baseline in Visual Analog Scale (VAS) at Day 30
Description
VAS pain assessment is a measure of pain intensity. The scale is made up of a 10 centimeter (cm) [100 millimeter (mm)] horizontal line. The far left of the horizontal line is labeled "no pain" while the far right of the horizontal line is labeled "worst imaginable pain". A negative change from Baseline indicates improvement. An ANCOVA model was used for analyses.
Time Frame
Baseline to Day 30
Title
Change From Baseline in Total WOMAC Score at Day 30
Description
The WOMAC is a tri-dimensional, disease-specific, patient-reported outcome measure. It consists of 24 questions [each question is presented in a numerical rating scale format with possible values between 0= No (best) to 10= Extreme (worst)] with 5 questions regarding pain [possible subscale score 0 to 50], 2 questions regarding stiffness [possible subscale score 0 to 20] and 17 questions regarding function difficulty [possible subscale score 0 to 170]. The WOMAC total score was calculated by summing the 3 subscales for a total possible score of 0 to 240. A negative change from Baseline indicates improvement. An ANCOVA model was used for analyses.
Time Frame
Baseline to Day 30
Title
Change From Baseline in VAS at Day 60
Description
VAS pain assessment is a measure of pain intensity. The scale is made up of a 10 cm (100 mm) horizontal line. The far left of the horizontal line is labeled "no pain" while the far right of the horizontal line is labeled "worst imaginable pain". A negative change from Baseline indicates improvement. An ANCOVA model was used for analyses.
Time Frame
Baseline to Day 60
Title
WOMAC Pain Score Responder Rate at Day 30
Description
WOMAC Pain Score Responder Rate is defined as the percentage of participants with at least a 30% reduction in the WOMAC pain score at Day 30 compared to Baseline. WOMAC is a tri-dimensional, disease-specific, patient-reported outcome measure. It consists of 24 questions [each question is presented in a numerical rating scale format with possible values between 0= No to 10= Extreme] with the first 5 questions regarding pain [possible subscale score 0 (best) to 50 (worst)].
Time Frame
Day 30
Title
VAS Responder Rate at Day 30
Description
VAS Responder Rate is defined as the percentage of participants with at least a 30% reduction in VAS at Day 30 compared to Baseline VAS pain assessment is a measure of pain intensity. The scale is made up of a 10 cm (100 mm) horizontal line. The far left of the horizontal line is labeled "no pain" while the far right of the horizontal line is labeled "worst imaginable pain".
Time Frame
Day 30
Title
Change From Baseline in Total WOMAC Score at Day 60
Description
The WOMAC is a tri-dimensional, disease-specific, patient-reported outcome measure. It consists of 24 questions [each question is presented in a numerical rating scale format with possible values between 0= No (best) to 10= Extreme (worst)] with 5 questions regarding pain [possible subscale score 0 to 50], 2 questions regarding stiffness [possible subscale score 0 to 20] and 17 questions regarding function difficulty [possible subscale score 0 to 170]. The WOMAC total score was calculated by summing the 3 subscales for a total possible score of 0 to 240. A negative change from Baseline indicates improvement.
Time Frame
Baseline to Day 60
Title
VAS Responder Rate at Day 60
Description
VAS Responder Rate is defined as the percentage of participants with at least a 30% reduction in VAS at Day 60 compared to Baseline. VAS pain assessment is a measure of pain intensity. The scale is made up of a 10 cm (100 mm) horizontal line. The far left of the horizontal line is labeled "no pain" while the far right of the horizontal line is labeled "worst imaginable pain".
Time Frame
Day 60
Title
WOMAC Pain Score Responder Rate at Day 60
Description
WOMAC Pain Score Responder Rate is defined as the percentage of participants with at least a 30% reduction in the WOMAC pain score at Day 60 compared to Baseline. WOMAC is a tri-dimensional, disease-specific, patient-reported outcome measure. It consists of 24 questions [each question is presented in a numerical rating scale format with possible values between 0= No (best) to 10= Extreme (worst)] with the first 5 questions regarding pain [possible subscale score 0 to 50].
Time Frame
Day 60
10. Eligibility
Sex
All
Minimum Age & Unit of Time
35 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
35 - 75 years of age
American College of Rheumatology (ACR) criteria for osteoarthritis of the knee. This includes radiographic evidence of osteophytes and at least one of the following: age ≥ 50 years old, morning stiffness ≤ 30 minute duration or crepitus on motion.
Grade II or III osteoarthritis of the knee as determined by Kellgren-Lawrence classification grading scale on anteroposterior (AP) x-ray within previous 6 months.
Participants are ambulatory without assistive devices.
Knee pain of ≥ 40 mm on Visual Analog Scale (VAS) when performing one of two movements that elicit the worst pain: standing from a seated position or walking up/down stairs.
Participant reports knee pain in the anterior and/or inferior aspect of the knee as documented on the knee pain map in the appropriate areas.
A diagnostic lidocaine (without epinephrine) block of the infrapatellar branch of the saphenous nerve results in a 50% reduction in the VAS pain assessment score when performing the activity that elicits the worst pain: standing from a seated position or walking up/down stairs.
Participant is able to tolerate a washout of prescription and over-the-counter pain relief for a duration of 5 times the half-life of the medication prior to the Baseline visit.
Participant is able to tolerate a washout of adjunctive therapies for knee pain for 72 hours prior to the Baseline visit.
Western Ontario and McMaster Osteoarthritis Index (WOMAC) NRS3.1 Pain subscore ≥ 20 at Baseline/Visit 2.
Participant is able to tolerate discontinuation of all pain medication throughout the duration of the study. Acetaminophen may be used as rescue medication with a maximum dose of 4g per day.
Participant is able to tolerate discontinuation of rescue medication, acetaminophen, for 24 hours prior to all follow-up visits.
Prescription and over-the-counter pain medications must be maintained on a stable schedule for at least two weeks prior to screening.
Participant is willing and able to give written informed consent.
Participant is willing and able to comply with study instructions and commit to all follow-up visits for the duration of the study.
Participant is in good general health and free of any systemic disease state or physical condition that might impair evaluation or which in the Investigator's opinion, exposes the Participant to an unacceptable risk by study participation.
Exclusion Criteria:
History of a partial or full knee replacement of the knee to be treated.
Planned partial or full knee replacement within the next 12 months in knee to be treated.
Previous myoscience Focused Cold Therapy^TM (FCTTM) treatment.
Viscosupplementation within the previous 6 months in knee to be treated.
Participant reports the majority of knee pain outside of the anterior/inferior aspect of the knee.
Intra-articular steroid injection in the knee to be treated within previous 3 months.
Gross deformity of the knee including varus or valgus.
Started physical therapy of the knee to be treated within 3 months of screening.
Received acupuncture for knee pain within 3 months prior to screening.
Body Mass Index ≥ 35.
Prior surgery in the treatment area that may alter the anatomy of the infrapatellar branch of the saphenous nerve or result in scar tissue in the treatment area.
Open and/or infected wound in the treatment area.
Disease of the spine, hip, contralateral knee or other lower extremity joint of sufficient degree affecting the assessment of the treated knee.
Acetaminophen intolerance or allergy.
Allergy to lidocaine.
History of cryoglobulinemia
History of paroxysmal cold hemoglobinuria.
History of cold urticaria.
History of Raynaud's disease.
History of pes anserinus bursitis in the knee to be treated.
Use of extended-release or long-acting opioids within previous 3 months.
Use of immediate-release opioids for more than 3 days per week within previous month.
Participant is pregnant or planning to become pregnant while enrolled in the study.
Current enrollment in any investigational drug or device study or participation within 30 days prior to screening.
Any additional diagnosis that in the opinion of the Investigator directly contributes to knee pain.
Any concomitant inflammatory disease or other condition that affects the joints (e.g. rheumatoid arthritis, metabolic bone disease, gout, active infection, etc.)
Any clotting disorder and/or use of an anticoagulant (e.g., aspirin, warfarin, clopidogrel, etc.) within seven (7) days prior to administration of the device.
Any local skin condition at the treatment site that in the Investigator's opinion would adversely affect treatment or outcomes.
Any chronic medical condition that in the Investigator's opinion would prevent adequate participation.
Any chronic medication use (prescription, over-the-counter, etc.) that in the Investigator's opinion would affect study participation or Subject safety.
For any reason, in the opinion of the Investigator, the Subject may not be a suitable candidate for study participation (i.e., history of noncompliance, drug dependency, any related knee injury due to a worker's compensation claim, etc.).
Known liver dysfunction.
Facility Information:
Facility Name
Medvin Clinical Research
City
Covina
State/Province
California
ZIP/Postal Code
91723
Country
United States
Facility Name
UC Davis Center for Musculoskeletal Health
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Coastal Orthopedics and Sports Medicine of Southwest Florida, PA
City
Bradenton
State/Province
Florida
ZIP/Postal Code
34203
Country
United States
Facility Name
Shrock Orthpedic Research
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33316
Country
United States
Facility Name
Health Awareness
City
Jupiter
State/Province
Florida
ZIP/Postal Code
33458
Country
United States
Facility Name
JM Clinical Research
City
South Miami
State/Province
Florida
ZIP/Postal Code
33143
Country
United States
Facility Name
Injury Care Medical Center
City
Boise
State/Province
Idaho
ZIP/Postal Code
83713
Country
United States
Facility Name
Rockford Orthopedic Associates, LTD
City
Rockford
State/Province
Illinois
ZIP/Postal Code
61114
Country
United States
Facility Name
Kansas University Medical Center
City
Fairway
State/Province
Kansas
ZIP/Postal Code
66205
Country
United States
Facility Name
Kansas City Bone and Joint Clinic
City
Overland Park
State/Province
Kansas
ZIP/Postal Code
66211
Country
United States
Facility Name
Covington Orthopedic and Sports Medicine Institute
City
Covington
State/Province
Louisiana
ZIP/Postal Code
70433
Country
United States
Facility Name
LHU HSC Department of Orthopaedics
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70112
Country
United States
Facility Name
Arthritis Treatment Center
City
Frederick
State/Province
Maryland
ZIP/Postal Code
21702
Country
United States
Facility Name
Triangle Orthopaedic Associates, P.A.
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27704
Country
United States
Facility Name
Blair Orthopedic Associates, Inc.
City
Altoona
State/Province
Pennsylvania
ZIP/Postal Code
16602
Country
United States
Facility Name
PCET Research Center
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37909
Country
United States
Facility Name
Spokane Joint Replacement Center
City
Spokane
State/Province
Washington
ZIP/Postal Code
99218
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
28336454
Citation
Radnovich R, Scott D, Patel AT, Olson R, Dasa V, Segal N, Lane NE, Shrock K, Naranjo J, Darr K, Surowitz R, Choo J, Valadie A, Harrell R, Wei N, Metyas S. Cryoneurolysis to treat the pain and symptoms of knee osteoarthritis: a multicenter, randomized, double-blind, sham-controlled trial. Osteoarthritis Cartilage. 2017 Aug;25(8):1247-1256. doi: 10.1016/j.joca.2017.03.006. Epub 2017 Mar 20.
Results Reference
derived
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Study to Evaluate the Iovera° Device for Temporary Relief From Knee Pain
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