A Prospective Study Evaluating the Treatment of Knee Osteoarthritis With the Cryo-Touch III Device

Over 100 million patients in the United States suffer from chronic pain. Chronic pain
conditions are often debilitating, taking a toll on a patient's physical and mental welfare.
Though a variety of pain management techniques currently exist, the most common nonsurgical
options provide slow-acting and/or short-term relief. Medication, often in the form of
non-steroidal anti-inflammatory drugs (NSAIDs) and opioids, comes with an array of side
effects such as nausea and vomiting. Medication also presents the possibility of more
serious effects such as increased risk of heart attack and stroke, and tolerance or
dependency issues. Surgical strategies tend to be reserved for more severe cases and are
limited by the risks and complications typically associated with surgery including bleeding,
bruising, scarring, and infection. A nonsurgical, minimally invasive, long-lasting approach
to chronic pain management is desirable.

The Cryo-Touch III is a pain management device developed for a novel, minimally invasive
procedure using focused cold therapy to target sensory nerve tissue and offer long-lasting
pain relief through cryoanalgesia. The device operates on the well-established cryobiology
principle that localized exposure to controlled moderately low temperature conditions can
alter tissue function. The therapy treats nerves with low temperatures via a cold probe in
the form of an assembly of small diameter needles, creating a highly localized treatment
zone around the probe. This focused cold therapy creates a conduction block that prevents
nerve signaling.

Though studies have proven efficacious in targeting motor nerves, the device's effect on
sensory nerves has yet to have been investigated in the clinical setting. The goal of the
study described herein is to evaluate the degree and duration of effect of the Cryo-Touch
III in reducing chronic pain by targeting sensory nerves.

Inclusion Criteria:

- Male or female, 18 years of age and older.

- Participants must meet American College of Rheumatology (ACR) criteria for
osteoarthritis of the knee (unilateral or bilateral). Clinical criteria includes knee
pain and at least three of the following 6 criteria: 50 years of age or older,
stiffness lasting less than 30 minutes, crepitus, bony tenderness, bony enlargement,
and/or no warmth to the touch.

- Any medications (prescription and/or over-the counter) must be maintained on a stable
schedule for ≥ 2 weeks prior to treatment. No washout period is allowed.

- An average Visual Analog Scale (VAS) for pain ≥ 4 over the last 30 days.

- Subject is willing and able to give written informed consent.

- Subject is willing and able to comply with study instructions and commit to all
follow-up visits for the duration of the study.

- Subject 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 subject to an unacceptable risk by study participation.

Exclusion Criteria:

- A partial or full knee replacement (in the treated knee).

- Any use of systemic injections (in any area) within the last 6 months.

- Current enrollment in an investigational drug or a device study that specifically
targets pain treatment.

- Any additional diagnosis that in the opinion of the investigator may directly
contribute to knee pain.

- Any concomitant inflammatory disease or other condition that affects the joints (e.g.
rheumatoid arthritis, metabolic bones disease, gout, active infection, etc.).

- Any clotting disorder and/or has used an anticoagulant (e.g., warfarin, clopidogrel,
etc.) within seven (7) days prior to administration of the device.

- Allergy or intolerance to lidocaine.

- 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.).