Patellar denervation in total knee arthroplasty without patellar resurfacing: a prospective, randomized controlled...

Area of Science:

• Orthopedic Surgery
• Pain Management
• Biomedical Engineering

Background:

• Anterior knee pain is a persistent complication following total knee arthroplasty (TKA).
• The precise etiology of anterior knee pain post-TKA remains unclear, with patellofemoral issues commonly implicated.
• Electrocautery offers a potential method for denervation of anterior knee structures to alleviate pain.

Purpose of the Study:

• To prospectively evaluate the efficacy of patellar denervation via electrocautery in reducing anterior knee pain after TKA.
• To compare clinical and radiological outcomes between knees undergoing patellar denervation and those receiving debridement alone.

Main Methods:

• A prospective randomized controlled trial involving 35 patients (70 knees) undergoing bilateral TKA.
• One patella per patient underwent denervation with electrocautery, while the contralateral patella received debridement and osteophyte removal.
• Knee Society Score (KSS) and Visual Analog Scale (VAS) were used for pre- and postoperative pain assessment.

Main Results:

• A statistically significant improvement in KSS, range of motion, and VAS scores was observed in the denervation group.
• Mean follow-up was 36 months, with no reported revisions, re-operations, or patellar fractures.
• Patellar denervation demonstrated superior outcomes compared to debridement alone for anterior knee pain.

Conclusions:

• Patellar denervation using electrocautery is a safe and effective technique for managing anterior knee pain in TKA patients not undergoing patellar resurfacing.
• The procedure leads to satisfactory clinical and radiological results, significantly reducing pain.
• This method provides a viable treatment option for refractory anterior knee pain post-TKA.