Does patellar denervation reduce post-operative anterior knee pain after total knee arthroplasty?

The effectiveness of patellar denervation in reducing anterior knee pain and improving patient satisfaction and quality of life after total knee arthroplasty (TKA) is still controversial. A meta-analysis was conducted to try to settle the controversy.

The electronic databases PubMed, Web of Science, Embase, and Cochrane Library were systematically searched. Of 374 papers identified, seven randomised controlled trials involving 898 patients (983 knees) were eligible for data extraction and meta-analysis.

Analysis showed that patellar denervation can significantly improve clinical outcomes for the first 12 months of follow-up after TKA, including anterior knee pain incidence (P = 0.008), visual analogue scale score (P < 0.001), patellar score (P < 0.001), Knee Society Score (P = 0.03), Knee Society Score function score (P = 0.03), and knee range of motion (P = 0.008). However, no statistical significance in outcomes was found between the patellar denervation group and no-denervation group for any of those parameters after 12 months of follow-up.

The best currently available evidence suggests that patellar denervation can significantly reduce anterior knee pain incidence and improve early clinical outcomes after TKA. However, after a prolonged period of follow-up, this advantage seems to disappear. Even so, the use of patellar denervation in primary TKA is recommended because it is safe and produces good early clinical outcomes.

Therapeutic study, Level II.