Yıl: 2022 Cilt: 29 Sayı: 11 Sayfa Aralığı: 1232 - 1237 Metin Dili: İngilizce DOI: 10.5455/annalsmedres.2022.04.126 İndeks Tarihi: 15-05-2023

Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty

Öz:
Aim: Anterior knee pain may lead to worse outcomes after total knee arthroplasty. The effect of patellar denervation (PD) by electrocautery on postoperative pain and function in patellar nonresurfacing TKA were assessed in this study. Materials and Methods: This retrospective study included patients with a minimum of 24 months follow-up who were operated for TKA between January 2014 and January 2018. Patellar Denervation (PD) group; patients who underwent circumpatellar electrocautery around the patella, and Control (C) group; who did not undergo. Patient demographics, preoperative patellofemoral osteoarthritis grades, Knee Society System (KSS) scores, Feller patella score (PS), Short Form-36 (SF-36) and visual analogue scale (VAS) scores at preoperative, postoperative 3. Month and last follow-up examination were noted. Results: There was no difference between groups in terms of gender distribution and age (p > 0.05). At 3rdpostoperative month, KSS-Knee was significantly higher and VAS score was significantly lower in the PD patients compared to C group (p=0.026, p=0.023 respectively). At the final follow-up, KSS-Function and PS scores were significantly higher (p=0.031, 0.012 respectively). Some of the QoL scores were better at late follow-up in PD group. However, there was no statistical difference between these two groups in other follow-up examinations (p > 0.05). Conclusion: Circumpatellar electrocautery denervation can be advantageous in reducing early postoperative knee pain. Clinical, functional and some of the QoL scores were better in the midterm postoperative period of patients with gonarthrosis treated by TKA with PD.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Canovas F, Dagneaux L. Quality of life after total knee arthroplasty. Orthop Traumatol Surg Res. 2018;104(1s):S41-s6.
  • 2. Fu Y, Wang G, Fu Q. Patellar resurfacing in total knee arthroplasty for osteoarthritis: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2011;19(9):1460-6.
  • 3. Judge A, Arden NK, Kiran A, Price A, Javaid MK, Beard D, et al. Interpretation of patient-reported outcomes for hip and knee replacement surgery: identification of thresholds associated with satisfaction with surgery. J Bone Joint Surg Br. 2012;94(3):412- 8.
  • 4. Parvizi J, Rapuri VR, Saleh KJ, Kuskowski MA, Sharkey PF, Mont MA. Failure to resurface the patella during total knee arthroplasty may result in more knee pain and secondary surgery. Clin Orthop Relat Res. 2005;438:191-6.
  • 5. Cheng T, Zhu C, Guo Y, Shi S, Chen D, Zhang X. Patellar denervation with electrocautery in total knee arthroplasty without patellar resurfacing: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2014;22(11):2648-54.
  • 6. Macule F, Sastre S, Lasurt S, Sala P, Segur JM, Mallofre C. Hoffa’s fat pad resection in total knee arthroplasty. Acta Orthop Belg. 2005;71(6):714-7.
  • 7. Wojtys EM, Beaman DN, Glover RA, Janda D. Innervation of the human knee joint by substance-P fibers. Arthroscopy. 1990;6(4):254-63.
  • 8. Maralcan G, Kuru I, Issi S, Esmer AF, Tekdemir I, Evcik D. The innervation of patella: anatomical and clinical study. Surg Radiol Anat. 2005;27(4):331-5.
  • 9. Vega J, Golano P, Perez-Carro L. Electrosurgical arthroscopic patellar denervation. Arthroscopy. 2006;22(9):1028 e1-3.
  • 10. Altay MA, Ertürk C, Altay N, Akmeşe R, Işıkan UE. Patellar denervation in total knee arthroplasty without patellar resurfacing: a prospective, randomized controlled study. Orthop Traumatol Surg Res. 2012;98(4):421-5.
  • 11. van Jonbergen HP, Scholtes VA, van Kampen A, Poolman RW. A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing. J Bone Joint Surg Br. 2011;93(8):1054-9.
  • 12. Pulavarti RS, Raut VV, McLauchlan GJ. Patella denervation in primary total knee arthroplasty - a randomized controlled trial with 2 years of follow-up. J Arthroplasty. 2014;29(5):977-81.
  • 13. Thiengwittayaporn S, Tangtrakul P, Hongku N, Tunyasuwanakul R. Patellar Denervation Reduces Postoperative Anterior Knee Pain After Patellar Resurfacing Total Knee Arthroplasty: A Randomized Controlled Trial. J Arthroplasty. 2021;36(4):1295-301.
  • 14. Budhiparama NC, Hidayat H, Novito K, Utomo DN, Lumban- Gaol I, Nelissen R. Does Circumferential Patellar Denervation Result in Decreased Knee Pain and Improved Patient-reported Outcomes in Patients Undergoing Nonresurfaced, Simultaneous Bilateral TKA? Clin Orthop Relat Res. 2020;478(9):2020-33.
  • 15. Baliga S, McNair CJ, Barnett KJ, MacLeod J, Humphry RW, Finlayson D. Does circumpatellar electrocautery improve the outcome after total knee replacement?: a prospective, randomised, blinded controlled trial. J Bone Joint Surg Br. 2012;94(9):1228-33.
  • 16. Namazi N, Jaberi FM, Pakbaz S, Vosoughi AR, Jaberi MM. Does patellar rim electrocautery have deleterious effects on patellar cartilage? Knee. 2014;21(2):524-8.
  • 17. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis. 1957;16(4):494-502.
  • 18. Crockarell JR, Jr. Polyethylene sterilized without irradiation in a polished uncemented acetabular component-a clinical and radiographic analysis. J Arthroplasty. 2008;23(6):911-5.
  • 19. Feller JA, Bartlett RJ, Lang DM. Patellar resurfacing versus retention in total knee arthroplasty. J Bone Joint Surg Br. 1996;78(2):226-8.
  • 20. Boonstra AM, Schiphorst Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31(2):165-9.
  • 21. Calvisi V, Camillieri G, Lupparelli S. Resurfacing versus nonresurfacing the patella in total knee arthroplasty: a critical appraisal of the available evidence. Arch Orthop Trauma Surg. 2009;129(9):1261-70.
  • 22. Keblish PA, Varma AK, Greenwald AS. Patellar resurfacing or retention in total knee arthroplasty. A prospective study of patients with bilateral replacements. J Bone Joint Surg Br. 1994;76(6):930-7.
  • 23. Burnett RS, Boone JL, Rosenzweig SD, Steger-May K, Barrack RL. Patellar resurfacing compared with nonresurfacing in total knee arthroplasty. A concise follow-up of a randomized trial. J Bone Joint Surg Am. 2009;91(11):2562-7.
  • 24. Gupta S, Augustine A, Horey L, Meek RM, Hullin MG, Mohammed A. Electrocautery of the patellar rim in primary total knee replacement: beneficial or unnecessary? J Bone Joint Surg Br. 2010;92(9):1259-61.
  • 25. van Jonbergen HP, Barnaart AF, Verheyen CC. A dutch survey on circumpatellar electrocautery in total knee arthroplasty. Open Orthop J. 2010;4:201-3.
  • 26. Kwon SK, Nguku L, Han CD, Koh YG, Kim DW, Park KK. Is Electrocautery of Patella Useful in Patella Non-Resurfacing Total Knee Arthroplasty?: A Prospective Randomized Controlled Study. J Arthroplasty. 2015;30(12):2125-7.
  • 27. Wilson NA, Press JM, Koh JL, Hendrix RW, Zhang LQ. In vivo noninvasive evaluation of abnormal patellar tracking during squatting in patients with patellofemoral pain. J Bone Joint Surg Am. 2009;91(3):558-66.
  • 28. Meneghini RM. Should the patella be resurfaced in primary total knee arthroplasty? An evidence-based analysis. J Arthroplasty. 2008;23(7 Suppl):11-4.
  • 29. Witonski D, Wagrowska-Danielewicz M. Distribution of substance-P nerve fibers in the knee joint in patients with anterior knee pain syndrome. A preliminary report. Knee Surg Sports Traumatol Arthrosc. 1999;7(3):177-83.
  • 30. Rand JA, Gaffey TA. Effect of electrocautery on fresh human articular cartilage. Arthroscopy. 1985;1(4):242-6.
  • 31. Yim SJ, Jang MS, Kim WJ, Lee SH, Kang HK. The Effect of Electrocautery around the Patellar Rim in Patellar Non- Resurfacing Total Knee Arthroplasty. Knee Surg Relat Res. 2012;24(2):104-7.
  • 32. Arslan A, Cuglan B, Ozkurt B, Utkan A, Korkmaz MF, Koca TT, Sevimli R. Is it Possible to Recover Cardiac Functions After Total Knee Arthroplasty? The Open Orthopaedics Journal. 2018;12:261.
APA Eken G, Bilgen M, yenigül a, Önder C, Artıra F, oguzkaya s (2022). Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty. , 1232 - 1237. 10.5455/annalsmedres.2022.04.126
Chicago Eken Gokay,Bilgen Mühammed Sadık,yenigül ali erkan,Önder Cem,Artıra Ferit Birand,oguzkaya sinan Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty. (2022): 1232 - 1237. 10.5455/annalsmedres.2022.04.126
MLA Eken Gokay,Bilgen Mühammed Sadık,yenigül ali erkan,Önder Cem,Artıra Ferit Birand,oguzkaya sinan Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty. , 2022, ss.1232 - 1237. 10.5455/annalsmedres.2022.04.126
AMA Eken G,Bilgen M,yenigül a,Önder C,Artıra F,oguzkaya s Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty. . 2022; 1232 - 1237. 10.5455/annalsmedres.2022.04.126
Vancouver Eken G,Bilgen M,yenigül a,Önder C,Artıra F,oguzkaya s Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty. . 2022; 1232 - 1237. 10.5455/annalsmedres.2022.04.126
IEEE Eken G,Bilgen M,yenigül a,Önder C,Artıra F,oguzkaya s "Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty." , ss.1232 - 1237, 2022. 10.5455/annalsmedres.2022.04.126
ISNAD Eken, Gokay vd. "Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty". (2022), 1232-1237. https://doi.org/10.5455/annalsmedres.2022.04.126
APA Eken G, Bilgen M, yenigül a, Önder C, Artıra F, oguzkaya s (2022). Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty. Annals of Medical Research, 29(11), 1232 - 1237. 10.5455/annalsmedres.2022.04.126
Chicago Eken Gokay,Bilgen Mühammed Sadık,yenigül ali erkan,Önder Cem,Artıra Ferit Birand,oguzkaya sinan Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty. Annals of Medical Research 29, no.11 (2022): 1232 - 1237. 10.5455/annalsmedres.2022.04.126
MLA Eken Gokay,Bilgen Mühammed Sadık,yenigül ali erkan,Önder Cem,Artıra Ferit Birand,oguzkaya sinan Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty. Annals of Medical Research, vol.29, no.11, 2022, ss.1232 - 1237. 10.5455/annalsmedres.2022.04.126
AMA Eken G,Bilgen M,yenigül a,Önder C,Artıra F,oguzkaya s Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty. Annals of Medical Research. 2022; 29(11): 1232 - 1237. 10.5455/annalsmedres.2022.04.126
Vancouver Eken G,Bilgen M,yenigül a,Önder C,Artıra F,oguzkaya s Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty. Annals of Medical Research. 2022; 29(11): 1232 - 1237. 10.5455/annalsmedres.2022.04.126
IEEE Eken G,Bilgen M,yenigül a,Önder C,Artıra F,oguzkaya s "Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty." Annals of Medical Research, 29, ss.1232 - 1237, 2022. 10.5455/annalsmedres.2022.04.126
ISNAD Eken, Gokay vd. "Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty". Annals of Medical Research 29/11 (2022), 1232-1237. https://doi.org/10.5455/annalsmedres.2022.04.126