Circumferential patellar denervation does not reduce anterior knee pain in total knee arthroplasty without patellar resurfacing; a prospective comparison

This study aimed to evaluate the effectiveness of circumferential patellar denervation in reducing anterior knee pain (AKP) and improving clinical outcomes after total knee arthroplasty (TKA) without patellar resurfacing. This prospective, non-randomized, observational study included patients who un...

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Bibliographic Details
Published in:	Journal of orthopaedic surgery and research Vol. 19; no. 1; pp. 653 - 10
Main Authors:	Dogruoz, Fırat, Yapar, Aliekber, Buyukarslan, Volkan, Egerci, Omer Faruk, Etli, Ibrahim, Kose, Ozkan
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 15-10-2024 BioMed Central BMC
Subjects:	Aged Analysis Anterior knee pain Arthralgia - etiology Arthralgia - surgery Arthroplasty, Replacement, Knee - methods Care and treatment Denervation Denervation - methods Female Humans Knee Joint - innervation Knee Joint - surgery Knee pain Kujala score Male Medical research Medicine, Experimental Middle Aged Osteoarthritis Osteoarthritis, Knee - surgery Pain Pain Measurement Pain, Postoperative - etiology Pain, Postoperative - prevention & control Patella - innervation Patella - surgery Patellar denervation Prospective Studies Range of Motion, Articular Total knee arthroplasty Treatment Outcome Visual Analog Scale WOMAC score Visual Analog Scale Kujala score Total knee arthroplasty Anterior knee pain Patellar denervation WOMAC score
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Summary:	This study aimed to evaluate the effectiveness of circumferential patellar denervation in reducing anterior knee pain (AKP) and improving clinical outcomes after total knee arthroplasty (TKA) without patellar resurfacing. This prospective, non-randomized, observational study included patients who underwent primary TKA at our institution between August 2023 and January 2024. Patients were divided into two groups: those who received patellar denervation (PD group) and those who did not (NPD group). The primary outcome was the reduction in anterior knee pain (AKP), measured by the Visual Analog Scale (VAS). Secondary outcomes included the Kujala Knee Score, Western Ontario and McMaster Universities Arthritis Index (WOMAC), and range of motion (ROM). Assessments were conducted preoperatively and at 3 and 6 months postoperatively. Four patients in the PD group and five in the NPD group were excluded from the study due to failure to complete follow-up. Thus, 74 female and 16 male patients with a mean age of 67.4 ± 4.2 years were included in the final analysis. There were no significant differences between the two groups with respect to age, sex, side of surgery, height, weight, BMI, grade of patellofemoral osteoarthritis, preoperative ROM, VAS score, Kujala score, and WOMAC score (p: n.s. for all variables). No significant differences were found between the groups for VAS, Kujala, and WOMAC scores at any time point (p: n.s.). Significant improvements in these scores over time were indicated by repeated measures ANOVA (p = 0.001 for both groups). Pairwise comparisons showed significant improvements from preoperative to postoperative months three and six and from postoperative months three to six (p = 0.001 for all comparisons). Both groups experienced decreased knee ROM at third month, which returned to preoperative values at sixth month with no significant differences. No complications were observed during the study. Circumferential patellar denervation does not provide additional benefit in reducing anterior knee pain or improving functional outcomes compared to the non-denervation approach in TKA without patellar resurfacing. Level III, Prospective comparative study.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	1749-799X 1749-799X
DOI:	10.1186/s13018-024-05161-5