Authors : Ashwin Shetty, Nikhil Manvi, Sanath Kumar Shetty
DOI : 10.18231/j.ijos.2019.014
Volume : 5
Issue : 1
Year : 2019
Page No : 83-87
Introduction: In post Total Knee Arthroplasty (TKA) patient’s anterior knee pain is considered to be a major problem. Anterior knee pain reduces patients satisfaction post TKA in almost one fourth of the cases. With an increase in number of TKA performed and higher demands of patients for quality of life, anterior knee pain attracts increasing attention from orthopaedic surgeons. Suggestions are there that anterior knee pain is caused due to distribution of nerve fibers and substance – P in soft tissue around the patella. Patella denervation by electro cautery can theoretically interrupt these pain receptors and reduce anterior knee pain. Hence, the aim of our study is to evaluate the effect of electro cautery on Patellar Non resurfacing TKA.
Materials and Methods: This is an observational study of the patients undergoing TKA (unilateral/bilateral) at from September 2016 to August 2018, diagnosed with Osteoarthritis (primary/secondary) of the knee joint. 66 patients were included into the study undergoing non resurfacing TKA, 33 underwent patellar rim cauterization and 33 were taken as control. Statistical analysis was evaluated with ROM, KSS (functional/objective), WOMAC and Feller's scoring at preoperative, 6weeks, 12weeks and 24 weeks postoperative periods.
Result: Significant improvement in the scores were noted from pre-operative to post-operative period in the patient who underwent patellar rim cauterization. But when compared between cautery and control group some statistically significant difference was noted in the KSS objective scoring in favor of circumpatellar cautery at 6weeks, but at 12 and 24 weeks no significant difference were noted. Whereas, no significant difference were found in the remaining scoring systems at 6, 12 and 24 weeks.
Conclusion: The use of electrocautery of patella rim in non-resurfacing total knee replacement had better results as per KSS objective scores at 6 weeks. However after 6 weeks follow up similar clinical outcomes were noted. Hence, we conclude electrocautery of patellar rim is not an effective measure for relieving anterior knee pain.
Keywords: Total knee arthroplasty, Electrocautery, Anterior knee pain, patellar rim MeSh terms- Arthroplasty, Knee joint, Patella, Osteoarthritis, Anterior knee pain, Patella innervation, Range of motion.