To determine the effect of circumpatellar electrocautery denervation in total knee arthroplasty without patellar resurfacing.
ID
Source
Brief title
Condition
- Joint disorders
- Bone and joint therapeutic procedures
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
12 months, 2 years and 4 years after total knee arthroplasty:
(1) Prevalence of anterior knee pain using the Clinical Anterior Knee Pain
Rating.
Secondary outcome
12 months, 2 years and 4 years after total knee arthroplasty:
(2) Pain on a Visual Analogue Scale (VAS)
Before surgery, and 12 months, 2 years and 4 years after total knee
arthroplasty:
(3) WOMAC 3.1 Osteoarthritis Index
(4) Knee Society Score
Background summary
Anterior knee pain occurs in up to 31% of patients after total knee
arthroplasty without patellar resurfacing, and in approximately 16% of patients
with patellar resufacing.
The cause of patellofemoral pain after total knee arthroplasty is unknown but
may at least be partly related to postoperative malalignment and anatomic
variations resulting in high patellofemoral contact forces. Immunohistochemical
studies on innervation of the anterior knee have found hyperinnervation in the
peripatellar soft tissues. In theory, circumpatellar denervation could result
in a lower prevalence of anterior knee pain.
To date, only one clinical study addressed the results of patellar denervation
in total knee arthroplasty. Although the results showed better pain relief
after patellar denervation, the number of patients randomized was small (40),
and no blinding was used. Randomized controlled trials to clarify the role of
patellar resurfacing during total knee arthroplasty used 200 patients or more
to achieve power to detect a significant difference.
Study objective
To determine the effect of circumpatellar electrocautery denervation in total
knee arthroplasty without patellar resurfacing.
Study design
Randomized prospective with intervention, blinded.
Intervention
Circumpatellar electrocautery denervation in total knee arthroplasty without
patellar resurfacing.
Study burden and risks
None
Postbus 5001
7400 GC Deventer
Nederland
Postbus 5001
7400 GC Deventer
Nederland
Listed location countries
Age
Inclusion criteria
Not applicable.
Exclusion criteria
Isolated patellofemoral osteoarthritis
Contralateral patellar resurfacing (primary or as revision)
Insufficient Dutch language skills
Total hip replacement or contralateral total knee replacement within the study period or less than one year before entering the study
Inflammatory arthritis
History of patellar fracture
Prior patellectomy
Patellofemoral instability
Prior unicondylar knee replacement
Previous high tibial or distal femoral osteotomy
Any prior operation involving the extensor mechanism
A severe medical disability that limits the ability to walk
Disabling disease involving other joints of the lower extremities
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
In other registers
| Register | ID |
|---|---|
| CCMO | NL21569.075.08 |
| OMON | NL-OMON24792 |