Background
Our study presents cases that were treated with Peripheral Nerve Stimulation HF-EMC Technology for treating patients after knee replacement surgery who failed all other pain management modalities.

Objectives
The primary objective of this retrospective review was to examine the responder rate (proportion of subjects experiencing greater than 50% relief) and changes in pain scores after the trial procedure, 3 months, 6 months, and 12 months post procedure.

Methods
A retrospective review was conducted to assess baseline and follow-up parameters. Inclusion criteria included adult subjects with residual chronic knee pain after total knee replacement. The 11-point Verbal Rating Scale (VRS) was used to assess pain scores. All subjects were implanted with a permanent Freedom PNS system at the infrapatellar saphenous nerve (IPS).

Results
At the end of the 7-day trial period, all 7 (100%) subjects reported more than 50% pain relief, with mean pain scores reducing from 9.5±0.5 to 1.3±0.5 (86%; p<0.001). The average VRS score at 1-month post-permanent implant decreased to 2.9±0.9 (69%; p<0.001). Six subjects reported mean VRS of 3.5±2.1 (63%; p<0.001) at three months. Five subjects reported a mean VRS of 3.8±2.2 (60%; p<0.001)  with four subjects reporting a mean pain score of 4 (58%; p<0.001)  after 12 months. All subjects reported improved mobility and quality of life. No adverse events were reported.

Conclusion
Peripheral nerve stimulation at the infrapatellar saphenous nerve with the Freedom PNS System demonstrates efficacy and safety in managing chronic knee pain after total knee replacement (TKR). This approach holds promise for patients with residual chronic pain after surgery, warranting further investigation and consideration in clinical practice.

Earl Kilbride is an experienced orthopedic surgeon based in Austin, Texas, with over 23 years of practice in the community. He is affiliated with the Austin Orthopedic Institute, where he specializes in sports medicine, adult reconstruction, trauma, and neuromodulation. His clinical interests include outpatient total joint surgery, complex knee injuries, traumatic joint injuries, and minimally invasive nerve stimulation for painful joints, both pre- and post-surgery. His specialties include knee replacement, shoulder, hip, and trauma. Dr. Kilbride is dedicated to providing compassionate, patient-centered care while advancing innovative orthopedic treatments.