D茅nervation patellaire dans la proth猫se totale du genou sans resurfa莽age patellaire聽: une 茅tude prospective, randomis茅e, contr么l茅e

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• 作者：M.A. Altay^a ; ^{maltay63@yahoo.com} ; ^{akifaltay@harran.edu.tr} ; C. Ertü ; rk^a ; N. Altay^b ; R. Akmeş ; e^c ; U.E. Iş ; ı ; kan^a
• 关键词：Patellar denervation ; Electrocautery ; Anterior knee pain ; Total knee arthroplasty
• 刊名：Revue de Chirurgie Orthop篓娄dique et Traumatologique
• 出版年：2012
• 期刊代码：pca328_18770517
• 类别：med
• 出版时间：June, 2012
• 卷：98
• 期：4
• 页码：376-377
• 文件大小：191 K

摘要

Summary

Background

Anterior knee pain is still a major problem in total knee arthroplasty (TKA). Although the most widely accepted opinion is that anterior knee pain is often associated with a patellofemoral etiology, there is no clear consensus as to etiology or treatment. Disabling pain receptors by electrocautery could theoretically achieve denervation of the anterior knee region. The present prospective randomized controlled study aimed to evaluate results after patellar denervation with electrocautery in TKA at a minimum follow-up of 2 years.

Hypothesis

Patellar denervation provides some benefit in terms of pain and clinical outcomes after TKA without patellar resurfacing.

Patients and methods

Clinical and radiological results for 35聽patients with single-stage bilateral TKA (70聽knees; 26聽women, nine men; mean age, 68 years [range, 58 to 77 years]) were reviewed. In addition to removal of all osteophytes, patellar denervation by electrocautery was performed on one patella; and debridement alone, removing all osteophytes, was performed on the contralateral patella, as a control. KSS score and a visual analog scale (VAS) were used to assess pre- and postoperative anterior knee pain.

Results

Mean follow-up was 36 months (24 to 60 months). No revisions or re-operations were performed. There were no patellar fractures. On all parameters (KSS score, range of motion and VAS), there was a statistically significant pre- to postoperative difference in favor of the denervation group.

Discussion

Patellar denervation with electrocautery can reduce anterior knee pain, with satisfactory clinical and radiological outcome, in TKA without patellar resurfacing.

Level of evidence

Level II: low-powered prospective randomized trial.