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Does patellar rim electrocautery have deleterious effects on patellar cartilage?
Niloofar Namazi1, Fereidoon Mojtahed Jaberi1, Sara Pakbaz2
1Bone and Joint Disease Research Center, Department of Orthopedic Surgery, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
The Knee
|February 8, 2014
Summary
Circumpatellar electrocauterization during total knee arthroplasty may harm patellar cartilage. Caution is advised when using this technique to manage postoperative knee pain.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Cartilage Biology
Background:
- Circumpatellar electrocauterization is a common technique to reduce pain after total knee arthroplasty (TKA) when the patella is not resurfaced.
- The potential impact of this denervation method on patellar cartilage health remains incompletely understood.
Purpose of the Study:
- To investigate the effects of circumpatellar electrocauterization on the integrity of patellar cartilage.
- To evaluate the histological and macroscopic changes in patellar cartilage following electrocauterization in a rabbit model.
Main Methods:
- A randomized controlled study was conducted with 20 rabbits, divided into case (electrocauterization) and control groups.
- Surgical procedures involved anterior midline skin incision and medial parapatellar arthrotomy, with electrocauterization applied to the patella in the case group.
- Cartilage evaluation included macroscopic assessment (Outerbridge score) and histopathological analysis 12 weeks post-surgery.
Main Results:
- The electrocauterization group showed significantly higher mean Outerbridge scores (2.0 vs. 0.37, p=0.002), indicating greater cartilage damage.
- Histopathological analysis revealed significant differences in cellularity (p=0.016), matrix loss (p=0.004), and chondrocyte clustering (p=0.008) in the electrocauterization group.
- Overall microscopic variables demonstrated statistically significant differences between the groups (p=0.001).
Conclusions:
- Circumpatellar electrocauterization can lead to significant patellar cartilage destruction.
- The findings suggest that routine use of electrocauterization in TKA without patellar resurfacing should be approached with caution due to potential adverse effects on cartilage.
