scholarly journals A prospective study to review the functional outcome between patellofemoral resurfacing versus non resurfacing in total knee replacement

2018 ◽  
Vol 4 (5) ◽  
pp. 757
Author(s):  
Sharat Balemane ◽  
Arshad Attar ◽  
Aaron Ruben Dsouza
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Pain Scale ◽  
Satisfaction Scale ◽  
Significant Difference ◽  
Total Knee ◽  
A Prospective Study ◽  
Anterior Knee

<p class="abstract"><strong>Background:</strong> A prospective study to review the functional outcome between patellofemoral resurfacing versus non resurfacing in posterior stabilized TKR.</p><p class="abstract"><strong>Methods:</strong> We studied a total of 63 patients with tricompartmental osteoarthritis of knee. These patients underwent total knee arthroplasty between April 2013 to September 2013 at Preethi hospital, Madurai. It was prospective study which was followed up for period of 1 year. There were two groups which were made randomly into patellofemoral resurfacing group (group A n=30) and the non resurfacing group (group B n=33). In the patellofemoral resurfacing group, patella was resurfaced with the help of cemented poly component and in the non-resurfacing group, the osteophytes of the patella was removed, it was reshaped to match the trochlea of the femoral prosthesis and circumpatellar denervation was done. Knee society score (KSS), anterior knee pain, knee society function score and patient satisfaction was compared between both the groups. <strong></strong></p><p class="abstract"><strong>Results:</strong> There was significant difference in anterior knee pain scale and incidence of anterior knee pain was less as compared in the resurfacing group. However 1 year of follow up of both groups concluded that there was no significant differences for functional outcomes. Patient satisfaction scale was significant in patellofemoral resurfacing group.</p><p class="abstract"><strong>Conclusions:</strong> Study showed that apart from significant improvement in anterior knee pain scale there was no significant difference for both groups after 1 year follow up in clinical outcome, except for patient satisfaction scale. For patellofemoral pain and severe patellofemoral arthritis it is recommended to perform patellar resurfacing, otherwise patellar resurfacing do not have any added advantage.</p>

scholarly journals Patelloplasty with and without circumpatellar denervation in reducing anterior knee pain in primary total knee arthroplasty: a comparative prospective study

2020 ◽  
Vol 6 (2) ◽  
pp. 270
Author(s):  
Sandeep Kumar Kanugula ◽  
Mallesh Rathod ◽  
Venugopal S. M.
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Intervention Group ◽  
Control Group ◽  
Significant Difference ◽  
Total Knee ◽  
Anterior Knee

<p class="abstract"><strong>Background:</strong> Anterior knee pain (AKP) following total knee arthroplasty (TKA) ­­­­­­is one of the complication which cause dissatisfaction in patients. Incidence estimated to be 4-49%. The aim of our study is to know the efficacy of patelloplasty with circumpatellar denervation with diathermy in reducing AKP in primary TKA.</p><p class="abstract"><strong>Methods:</strong> A total of 130 unilateral TKAs’ are divided into 2 groups. Group I (control) includes 65 patients in which only patelloplasty was done. Group II (intervention) includes 65 patients in which both patelloplasty and circumpatellar denervation with diathermy was done and analysed. Mean follow up period was 18 months. Patients were assessed both preoperatively and postoperatively at final follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> The overall incidence of AKP at follow up (18 months) was 16.9%, with 7.7% in the intervention group and 26.1% in the control group (p&lt;0.05).  Western Ontario and McMaster Universities osteoarthritis index scores were significantly  better in intervention group when compared to control group (28.71±3.948 vs 31.40±3.860). Better results were also found in knee society scores for intervention group compared to control group (166.57±7.941 vs 161.23±11.219); Feller patellar score of  intervention group was significantly better when compared to control group (23.28±2.546 vs 20.69±3.729); the range of knee flexion was similar in both the groups (94.62±12.6 vs 93.54±10.7). In terms of pain referred by the patient at 72 hrs postoperatively, there was statistically significant difference observed according to visual analogue scale.</p><p class="abstract"><strong>Conclusions:</strong> There is statistically significant difference with respect to AKP in patients who have undergone patelloplasty with circumpatellar denervation using diathermy compared with patelloplasty alone.</p><p> </p>

scholarly journals Does patellar denervation prevent anterior knee pain and improve patient-reported outcomes in patients undergoing non-resurfaced total knee arthroplasty? an updated meta-analysis of randomized controlled trials.

2020 ◽  
Author(s):  
Hongzhi Liu ◽  
Zhaohui Liu ◽  
Qidong Zhang ◽  
Wanshou Guo
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Difference ◽  
Patient Reported ◽  
Total Knee ◽  
Anterior Knee

Abstract Background Anterior knee pain (AKP) is the most common complication of total knee arthroplasty (TKA). It is unclear which procedure of addressing AKP is preferable. Some data suggest patellar denervation (PD) provides effective AKP prevention. The purpose was to assess the effectiveness and safety of PD in primary TKA.Methods A meta-analysis was performed of randomized clinical trials (RCTs) from inception to March 26, 2020, using PubMed, Embase, Web of Science and Cochrane Library. Study-specific RR and MD were aggregated using random or fixed effects models. The outcomes were incidences of AKP, PS (patellar scores), VAS (visual analogue scale), ROM (range of motion), KSS knee (American Knee Society knee scores), KSS function (American Knee Society function scores), incidence of complications and revisions.Results Ten RCTs involving 1196 knees were included. The meta-analysis showed no significant in PD group on the incidence of AKP (RR = 0.64; 95% CI 0.37, 1.11; p = 0.11) with moderate heterogeneity (P < 0.01, I2 = 84%). Our results indicated PD had a significantly better VAS (MD = − 0.25; 95% CI -0.41, -0.09; p < 0.01), ROM (MD = 7.68; 95% CI 0.34, 15.20; p = 0.04) and PS (MD = 0.91; 95% CI 0.36, 1.46; p < 0.01). However, there was no significant difference no matter in KSS knee, KSS function, complications or revisions.Conclusions This meta-analysis showed that no difference in AKP between PD and NPD in patients undergoing non-resurfaced TKA. PD could improve clinical outcome in VAS, post-operative ROM and PS.

A prospective study of the diagnostic potential of the knee tunnel view radiograph in assessing anterior knee pain

The Knee ◽  
2007 ◽  
Vol 14 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Caroline Hing ◽  
Eden Raleigh ◽  
Michael Bailey ◽  
Nasir Shah ◽  
Tom Marshall ◽  
...  
Keyword(s):  
Prospective Study ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Diagnostic Potential ◽  
A Prospective Study ◽  
Anterior Knee

Analysis of isokinetic parameters in the development of anterior knee pain syndrome: A prospective study in a military setting

2004 ◽  
Vol 12 (4) ◽  
pp. 223-228 ◽  
Author(s):  
Damien Van Tiggelen ◽  
Erik Witvrouw ◽  
Pascal Coorevits ◽  
Jean-Louis Croisier ◽  
Philippe Roget
Keyword(s):  
Prospective Study ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Pain Syndrome ◽  
A Prospective Study ◽  
Anterior Knee

scholarly journals Patelloplasty in total knee arthroplasty with circumpatellar denervation versus without denervation – a randomized prospective study

Arthroplasty ◽  
2020 ◽  
Vol 2 (1) ◽  
Author(s):  
S. R. K. Deekshith ◽  
K. J. Reddy ◽  
R. Raviteja
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Kujala Score ◽  
Significant Difference ◽  
Total Knee ◽  
The Mean ◽  
Anterior Knee

Abstract Introduction Anterior knee pain is one of the major problems in total knee arthroplasty (TKA) and is often etiologically associated with a patellofemoral parts etiology. There is no consensus as to etiology or treatment. Denervation of the patella by electrocautery and patelloplasty along with removal of osteophytes have been used for treatment of anterior knee pain in TKA. The purpose of our study was to compare, in terms of the anterior knee pain and clinical outcomes of patelloplasty in total knee arthroplasty (TKA), patellar denervation by electrocautery and non-patellar-denervation treatment in a 2 year follow-up. Materials and methods This study was conducted in a total of 108 patients, who underwent TKA at our institution between June 2015 and December 2016. Patients age 55 to 80 years, who are suffering from osteoarthritis, rheumatoid arthritis of knee were included in this study. Patients were randomly allocated into patelloplasty with denervation group and non-denervation group. The denervation of the patella was done in electrocautery group using a monopolar coagulation diathermy set to 50 W. (Valleylab Inc., Boulder, CO). Postoperatively, patients were assessed at regular intervals of 3, 6, 9, 12, 24 months. To assess patient outcomes, we used questionnaires to determine the Knee Society score (KSS - knee and function scores), a specific patellofemoral pain questionnaire (Kujala score) range of motion (ROM) and a visual analogue scale (VAS) to assess anterior knee pain. Results The data obtained were analyzed using SPSS version 17.0. Continuous variables were expressed as mean ± SD. Of the 108 patients, 9 patients were lost to follow-up. Among the remaining 99 patients, 50 were included in denervation group and 49 in non-denervation group. In our study, there was no statistically significant difference in Mean KUJALA score preoperatively (p > 0.05). Postoperatively, the mean KUJALA score was significantly higher in denervation group at 3, 6, 9, 12, 24 months of follow-up when compared to TKR with no denervation (p < 0.05). There was no statistically significant difference in Mean VAS score preoperatively (p > 0.05). However, 6, 12 and 24 months after the operation, the mean VAS score was significantly lower in denervation group. There was no statistically significant difference in Mean KSS score preoperatively and postoperatively (p > 0.05). The mean ROM was significantly higher in denervation group than in the group of TKR with no denervation (p < 0.05). Conclusion In our study, less postoperative anterior knee pain, increased range of motion, significantly lower VAS scores were seen in the denervation group compared with non-denervation group. Circumferential denervation of patella during primary TKA along with patellar resurfacing is a safe procedure that improves patient satisfaction, decreases anterior knee pain and improves range of flexion in the postoperative period and at postoperative follow-ups.

scholarly journals A Dutch Survey on Circumpatellar Electrocautery in Total Knee Arthroplasty

2010 ◽  
Vol 4 (1) ◽  
pp. 201-203 ◽  
Author(s):  
Hans-Peter W. van Jonbergen ◽  
Alexander F.W. Barnaart ◽  
Cees C.P.M. Verheyen
Keyword(s):  
Total Knee Arthroplasty ◽  
The Netherlands ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Patellar Resurfacing ◽  
Orthopedic Surgeons ◽  
Unicompartmental Knee Arthroplasties ◽  
Total Knee ◽  
Anterior Knee

Introduction: Anterior knee pain following total knee arthroplasty is estimated to occur in 4-49% of patients. Some orthopedic surgeons use circumpatellar electrocautery (diathermy) to reduce the prevalence of postsurgical anterior knee pain; however, the extent of its use is unknown. Materials and Methodology: In April 2009, a postal questionnaire was sent to all 98 departments of orthopedic surgery in The Netherlands. The questions focused on the frequency of total knee arthroplasties, patellar resurfacing, and the use of circumpatellar electrocautery. Results: The response rate was 92%. A total of 18,876 TKAs, 2,096 unicompartmental knee arthroplasties, and 215 patellofemoral arthroplasties are performed yearly in The Netherlands by the responding orthopedic surgeons. Of the orthopedic surgeons performing TKA, 13% always use patellar resurfacing in total knee arthroplasty for osteoarthritis, 49% use selective patellar resurfacing, and 38% never use it. Fifty-six percent of orthopedic surgeons use circumpatellar electrocautery when not resurfacing the patella, and 32% use electrocautery when resurfacing the patella. Conclusion: There is no consensus among Dutch orthopedic surgeons on the use of patellar resurfacing or circumpatellar electrocautery in total knee replacement performed for osteoarthritis. A prospective clinical trial is currently underway to fully evaluate the effect of circumpatellar electrocautery on the prevalence of anterior knee pain following total knee arthroplasty.

Intrinsic Risk Factors for the Development of Anterior Knee Pain in an Athletic Population: A Two-Year Prospective Study

2000 ◽  
Vol 28 (4) ◽  
pp. 480-489 ◽  
Author(s):  
Erik Witvrouw ◽  
Roeland Lysens ◽  
Johan Bellemans ◽  
Dirk Cambier ◽  
Guy Vanderstraeten
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Athletic Population ◽  
Anterior Knee

Higher Function Scores and Satisfaction in Patients with Anteromedial Osteoarthritis Compared with Other Wear Patterns of the Knee: 2 Years after Both Total and Unicondylar Knee Arthroplasties

2019 ◽  
Vol 33 (07) ◽  
pp. 629-635
Author(s):  
Suzanne Witjes ◽  
Alexander Hoorntje ◽  
Koen L. M. Koenraadt ◽  
Gino M. M. J. Kerkhoffs ◽  
Rutger C. I. van Geenen
Keyword(s):  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Cross Sectional Study ◽  
Pain Scale ◽  
Specific Function ◽  
Cross Sectional ◽  
Wear Pattern ◽  
Unicondylar Arthroplasty ◽  
Anterior Knee

AbstractAnteromedial osteoarthritis (AMOA) is a common wear pattern in primary osteoarthritic knees. In patients with bone-on-bone disease, the most appropriate surgical intervention is still a matter of debate. Knee arthroplasty is a well-accepted treatment to relieve symptoms and regain function. Unfortunately, satisfaction is limited, especially related to activities. A cross-sectional study was performed among patients treated with total knee arthroplasty (TKA) and unicondylar arthroplasty (UKA) to determine if the osteoarthritis wear pattern or type of prosthesis affects knee-specific function scores and satisfaction related to activities. All UKA patients (N = 100) were treated for AMOA. Based on radiological assessment of the wear pattern, TKA patients were divided into two groups: TKA for AMOA (N = 68) and true TKA (N = 99). The Knee injury and Osteoarthritis Outcomes Score (KOOS), new Knee Society score (KSS), anterior knee pain scale, visual analog scales (VASs) for satisfaction about activities, and net promoter score were collected. After 2 years' follow-up, the anterior knee pain scale and VAS satisfaction showed significantly better scores for patients treated with TKA for AMOA compared with the true TKA group. Also in the KOOS subscales, some differences were seen in favor of the TKA for AMOA group. The new KSS was not in favor of a specific wear pattern, but patients with AMOA treated with UKA performed better on the symptoms subscale compared with patients treated with TKA. In conclusion, patients treated with TKA for AMOA showed better knee-specific function scores and satisfaction scores compared with patients treated with TKA for other wear patterns, and only slight differences were found between both the AMOA groups (TKA for AMOA and UKA). Thus, the radiologic assessment of wear patterns might be useful to take into account the shared decision-making process, when discussing expectations, timing, and outcomes with knee osteoarthritis patients considering knee arthroplasty. When AMOA is present, it might be beneficial to choose UKA over TKA.

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