Patella denervation in total knee arthroplasty
Research type
Research Study
Full title
Patella denervation with circumferencial diathermy in total knee arthroplasty: A randomised controlled trial.
IRAS ID
48186
Contact name
Bilal Jamal
Contact email
Research summary
Summary of Results
Methods
We conducted a single centre double blind randomised controlled trial. Patients aged 40 years or older and booked to undergo a total knee arthroplasty were recruited from a single centre. All patients underwent total knee arthroplasty without patella resurfacing. Participants were blinded to treatment allocation. There was no cross-over. The primary outcome was Oxford Knee Score (OKS) at 1-year post-operatively. Secondary outcomes were Bartlett Patella Score, WOMAC, SF-12. Linear regression analysis was performed with adjustment by age, sex, and baseline (pre-operative) scores.Results
142 participants were recruited of which 49 patients (35%) were randomised to the denervation intervention. The mean patient age was 71-years and 51% (74/142) were female. No difference in OKS was detected at 1-year (mean difference [MD] 1.87; 95% CI -1.28 to 5.03). No difference was detected in Bartlett Patella Score (MD 0.490; 95% CI -1.61 to 2.59) or SF-12 (MD 0.196; 95% CI -2.54 to 2.93). A statistically significant difference in WOMAC was detected but at a level less than the minimal clinically important difference for WOMAC (MD 4.79; 95% CI 1.05 to 8.52) and at 2-years, no significant difference was observed in any of the outcome measures.Conclusion
No clinically important benefit was detected from patella rim electrocautery in patients undergoing total knee arthroplasty without patella resurfacing (including no benefit in terms of post-TKA anterior knee pain). This treatment is therefore not recommended for clinical practice.REC name
West of Scotland REC 1
REC reference
13/WS/0033
Date of REC Opinion
21 Mar 2013
REC opinion
Further Information Favourable Opinion