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. 2018 Jan 30:7:9.
doi: 10.4103/abr.abr_154_16. eCollection 2018.

Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty

Mehdi Motififard  1 , Khalilollah Nazem  1 , Aida Zarfeshani  2 , Kaveh Zarfeshani  1
Affiliations

Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty

Mehdi Motififard et al. Adv Biomed Res. .

Abstract

Background: Anterior knee pain is a major problem in total knee arthroplasty (TKA). It is accepted that anterior knee pain (AKP) often contributes to a patellofemoral etiology; however, its etiology or treatment is not understood completely. Disabling pain receptors by electrocautery could theoretically lead to anterior knee area denervation. The present study aimed to evaluate the pain post-patellar denervation (PD) with electrocautery in TKA.

Materials and methods: Clinical results for 92 patients who underwent TKA (58 women, 34 men; mean age 67.5 years) were analyzed. In addition to removal of all osteophytes, PD by electrocautery was performed on patella of treatment group (n = 46) and debridement alone including removing of all osteophytes was performed on the control group (n = 46). Knee Society System (KSS) score, patella score (PS), and visual analog scale (VAS) were used to determine pre- and post-operative AKP.

Results: The follow-up duration was 10 months. No revision or reoperations were performed. There were no patellar fractures. On all parameters (KSS score, PS, and VAS), there was a statistically significant pre- to post-operative difference in favor of the denervation group only 3 weeks after operation; however, there was no statistically difference postoperation on other follow-ups (3, 6, and 10 months).

Conclusions: PD with electrocautery could reduce AKP in TKA without patellar resurfacing only in a short-term period postoperation.

Keywords: Denervation; patella; total knee arthroplasty.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Study flow diagram. NPD: Nonpatellar denervation; PD: Patellar denervation
See this image and copyright information in PMC

References

    1. Muoneke HE, Khan AM, Giannikas KA, Hägglund E, Dunningham TH. Secondary resurfacing of the patella for persistent anterior knee pain after primary knee arthroplasty. J Bone Joint Surg Br. 2003;85:675–8. - PubMed
    1. Smith AJ, Wood DJ, Li MG. Total knee replacement with and without patellar resurfacing: A prospective, randomised trial using the profix total knee system. J Bone Joint Surg Br. 2008;90:43–9. - PubMed
    1. van Jonbergen HP, Barnaart AF, Verheyen CC. A Dutch survey on circumpatellar electrocautery in total knee arthroplasty. Open Orthop J. 2010;4:201–3. - PMC - PubMed
    1. Swan JD, Stoney JD, Lim K, Dowsey MM, Choong PF. The need for patellar resurfacing in total knee arthroplasty: A literature review. ANZ J Surg. 2010;80:223–33. - PubMed
    1. Pavlou G, Meyer C, Leonidou A, As-Sultany M, West R, Tsiridis E. Patellar resurfacing in total knee arthroplasty: Does design matter? A meta-analysis of 7075 cases. J Bone Joint Surg Am. 2011;93:1301–9. - PubMed