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

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 theoretic...

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Autores principales: Motififard, Mehdi, Nazem, Khalilollah, Zarfeshani, Aida, Zarfeshani, Kaveh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812092/
https://www.ncbi.nlm.nih.gov/pubmed/29456980
http://dx.doi.org/10.4103/abr.abr_154_16
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author Motififard, Mehdi
Nazem, Khalilollah
Zarfeshani, Aida
Zarfeshani, Kaveh
author_facet Motififard, Mehdi
Nazem, Khalilollah
Zarfeshani, Aida
Zarfeshani, Kaveh
author_sort Motififard, Mehdi
collection PubMed
description 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.
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spelling pubmed-58120922018-02-16 Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty Motififard, Mehdi Nazem, Khalilollah Zarfeshani, Aida Zarfeshani, Kaveh Adv Biomed Res Original Article 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. Medknow Publications & Media Pvt Ltd 2018-01-30 /pmc/articles/PMC5812092/ /pubmed/29456980 http://dx.doi.org/10.4103/abr.abr_154_16 Text en Copyright: © 2018 Advanced Biomedical Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Motififard, Mehdi
Nazem, Khalilollah
Zarfeshani, Aida
Zarfeshani, Kaveh
Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty
title Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty
title_full Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty
title_fullStr Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty
title_full_unstemmed Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty
title_short Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty
title_sort effect of patellar electrocautery neurectomy on postoperative pain among patients referred for total knee arthroplasty
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812092/
https://www.ncbi.nlm.nih.gov/pubmed/29456980
http://dx.doi.org/10.4103/abr.abr_154_16
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