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Effect of patellar denervation by circumpatellar electrocautery on clinical outcomes of patients with total knee arthroplasty running title: Patellar denervation in knee arthroplasty

Gökay Eken,Muhammed Sadık Bilgen,Ali Erkan Yenigül,Sinan Oğuzkaya,Cem Önder,Ferit Birand Artıran.

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Objective: Anterior knee pain may lead to worse outcomes after total knee arthroplasty. The effect of patellar denervation (PD) by electrocautery on postoperative pain and function in patellar nonresurfacing TKA were assessed in this study.
Materials and Methods: This retrospective study included patients with a minimum of 24 months follow-up who were operated for TKA between January 2014 and January 2018. Patellar Denervation (PD) group; patients who underwent circumpatellar electrocautery around the patella, and Control (C) group; who did not underwent. Patient demographics, preoperative patellofemoral osteoarthritis grades, Knee Society System (KSS) scores, Feller patella score (PS), Short Form-36 (SF-36) and visual analog scale (VAS) scores at preoperative, postoperative 3. Month and last follow-up examination were noted.
Results: There was no difference between groups in terms of gender distribution and age (P > 0.05). At 3rd postoperative month, KSS-Knee was significantly higher and VAS score was significantly lower in the PD patients compared to C group (p=0.026, p=0.023 respectively). At the final follow-up, KSS-Function and PS scores were significantly higher (p=0.031, 0.012 respectively). Some of the QoL scores were better at late follow-up in PD group. However, there was no statistical difference between these two groups in other follow-up examinations (p > 0.05).
Conclusion: Circumpatellar electrocautery denervation can be advantageous in reducing early postoperative knee pain. Clinical, functional and some of the QoL scores were better in the midterm postoperative period of patients with gonarthrosis treated by TKA with PD.

Key words: Denervation, patella, total knee arthroplasty, circumpatellar electrocautery

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