I had the Iovera but not the surgery, I cancelled for other reasons but can't imagine having the pain from the surgery and also the pain from the Iovera. I had 1 procedure that involved 3 injections, if I'm understanding your question correctly. It was done by a doctor and I believe Iovera was all he did. I don't think everyone has the problems I had so it's a chance you have to be willing to take but I did, and still have occasionally, the zingers from the Iovera. They aren't that bad and kind of welcome because that tells me that the nerves are healing. But the pain from the Iovera was intense, very sensitive spots where nothing could touch it without the pain, and I still have slight numbness after 9 months. I would not have it again and might not have the TKR either. Taking too many chances for poor outcome. I too am concerned about pain medication.