Abstract: A prospective patient-blindclinical trial was carried in 20 candidates (patellar denervation in the right knee using circumferential cauterization, besides classical patelloplasty; and no denervation/patelloplasty to left knee) of simultaneous bilateral total knee arthroplasty (TKA) for end-stage osteoarthritis to assess the efficacy of patellar denervation in reducing anterior knee pain (AKP) following TKA. Presence, intensity and functional impact of AKP was compared between denervated (right) and non-denervated (left) knee using physical examination, visual analogous scale (VAS) and Kujala score, respectively; in addition to quadriceps diameter and sustained isometric exercise. Evolution over time of AKP was compared by 2-time assessment of pain intensity (< 1 year versus >1 year) using VAS. Eighteen patients completed the study. Prevalence (95%CI) of self-reported AKP was 22.2%; physical examination revealed that 61.1% patients had pain on patellofemoral compression; 16.7% had tender medial facet, and tender femoral grove each. No differences between denerveted and non-denerveted knees regarding pain intensity (VAS score=5.00±2.83 versus 5.11±2.72; p=0.317) or knee function (Kujala score=65.94±7.73 versus 67.17±11.60; p=0.346) were observed, respectively. Other assessments showed no difference in quadriceps diameter (p=0.375) or sustained isometric exercise (p=0.494). A significant decrease in pain was found over time in both denervated and non denervated knees, with no difference in change in pain intensity.This trial showed no efficacy of patellar denervation in reducing AKP following bilateral-TKA. Further trials are warranted to verify this result.
Keywords: Anterior knee pain; total knee arthroplasty; knee replacement; patellar denervation.
Title: Efficacy of Patellar Denervation on Anterior Knee Pain and Knee Function Following Total Knee Arthroplasty: A Prospective Single-blind Clinical Trial
Author: Abbass M, Alkaff M, Alharbi A
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
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