Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty

Abstract

Background: Anterior knee pain is a major problem in total knee arthroplasty (TKA). It is accepted that anterior knee pain (AKP) often contributes to a patellofemoral etiology; however, its etiology or treatment is not understood completely. Disabling pain receptors by electrocautery could theoretically lead to anterior knee area denervation. The present study aimed to evaluate the pain post-patellar denervation (PD) with electrocautery in TKA. Materials and Methods: Clinical results for 92 patients who underwent TKA (58 women, 34 men; mean age 67.5 years) were analyzed. In addition to removal of all osteophytes, PD by electrocautery was performed on patella of treatment group (n = 46) and debridement alone including removing of all osteophytes was performed on the control group (n = 46). Knee Society System (KSS) score, patella score (PS), and visual analog scale (VAS) were used to determine pre- and post-operative AKP. Results: The follow-up duration was 10 months. No revision or reoperations were performed. There were no patellar fractures. On all parameters (KSS score, PS, and VAS), there was a statistically significant pre- to post-operative difference in favor of the denervation group only 3 weeks after operation; however, there was no statistically difference postoperation on other follow-ups (3, 6, and 10 months). Conclusions: PD with electrocautery could reduce AKP in TKA without patellar resurfacing only in a short-term period postoperation.

Keywords

• Denervation
• patella
• total knee arthroplasty