Relationship Study In Anterior Knee Pain And Patella Treatment After Primary Total Knee Arthroplasty

ObjectiveTo explore the effectiveness and security of patellar denervation combined with patellar replacement and patellar denervation alone in the improvement of clinical function and the reduction of anterior knee pain in patients undergoing primary total knee arthroplasty.MethodsForty-eight patients with severe knee osteoarthritis who underwent bilateral primary total knee arthroplasty and were treated with a unilateral patellar replacement on one side in the Department of Orthopaedics of Peking Union Medical College Hospital from July 2013 to March 2015 were retrospectively analyzed.All patients adopted total knee prostheses of the same brand and same model.In primary total knee arthroplasty,patellar denervation combined with patellar replacement was carried out on unilateral knee joint,and the contralateral knee joint was treated with patellar denervation alone.Postoperative pain,joint function,imaging findings and complications were evaluated.Numerical clinical data were expressed as mean ± standard deviation,and categorical variables were displayed as the number of cases(constituent ratio).The numerical variables were analyzed using the paired t-test,and the categorical variables were analyzed by the chisquare test.P<0.05 was considered as statistically significant.Resultshere were no statistically significant differences in KSS clinical score,KSS functional score or patellar Feller score between patellar denervation combined with patellar replacement and patellar denervation alone conducted in primary total knee arthroplasty.After the surgery,80%(24/30)of patients had no preference for pain or function of both knee joints.However,10%(3/30)patients preferred the side undergoing patellar replacement,while 10%(3/30)patients preferred the side without patellar replacement.Follow-up images showed that the patellar prosthesis was in good position and patellar trajectory in the patellar denervation combined with patellar replacement and the patellar denervation alone,with no obvious loosening and wear of the prosthesis.In terms of complications after TKA,poor joint adhesion activity was observed in 2 cases(6.7%)inhe patellar denervation combined with patellar replacement,3 cases(20%)in the patellar denervation alone.There were no postoperative complications such as lower limb venous thrombosis,aseptic fracture around prosthesis and infection in 2 groups.ConclusionsThere is no statistically significant difference in the therapeutic effect between patellar denervation combined with patellar replacement and patellar denervation alone conducted in patients with knee osteoarthritis undergoing primary total knee arthroplasty.AbbreviationsTKA=total knee arthroplasty,HSS=Hospital for Special Surgery,RCT=randomized controlled trial,nRCT=non-randomized controlled trials,VAS=visual analogue scale,KOOS=Knee Injury and Osteoarthritis Outcome Score...