Does circumpatellar electrocautery improve the outcome after total knee replacement?

S Baliga, CJ McNair, KJ Barnett, J MacLeod, RW Humphry, D Finlayson

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

The incidence of anterior knee pain following total knee replacement (TKR) is reported to be as high as 49%. The source of the pain is poorly understood but the soft tissues around the patella have been implicated. In theory circumferential electrocautery denervates the patella thereby reducing efferent pain signals. However, there is mixed evidence that this practice translates into improved outcomes. We aimed to investigate the clinical effect of intra-operative circumpatellar electrocautery in patients undergoing TKR using the LCS mobile bearing or Kinemax fixed bearing TKR. A total of 200 patients were randomised to receive either circumpatellar electrocautery (diathermy) or not (control). Patients were assessed by visual analogue scale (VAS) for anterior knee pain and Oxford knee score (OKS) pre-operatively and three months, six months and one year post-operatively. Patients and assessors were blinded. There were 91 patients in the diathermy group and 94 in the control. The mean VAS improvement at one year was 3.9 in both groups (control; -10 to 6, diathermy; -9 to 8, p < 0.001 in both cases, paired, two-tailed t-test). There was no significant difference in VAS between the groups at any other time. The mean OKS improvement was 17.7 points (0 to 34) in the intervention group and 16.6 (0 to 42) points in the control (p = 0.36). There was no significant difference between the two groups in OKS at any other time. We found no relevant effect of patellar electrocautery on either VAS anterior knee pain or OKS for patients undergoing LCS and Kinemax TKR.
Original languageEnglish
Pages (from-to)1228 - 1233
Number of pages6
JournalThe Journal of Bone and Joint Surgery
Volume94
Publication statusFirst published - 2012

Fingerprint

Knee Replacement Arthroplasties
Electrocoagulation
Knee
Diathermy
Pain
Visual Analog Scale
Patella
Control Groups
Incidence

Bibliographical note

2060744

Keywords

  • Electrocautery
  • Knee replacement

Cite this

Baliga, S., McNair, CJ., Barnett, KJ., MacLeod, J., Humphry, RW., & Finlayson, D. (2012). Does circumpatellar electrocautery improve the outcome after total knee replacement? The Journal of Bone and Joint Surgery, 94, 1228 - 1233.
Baliga, S ; McNair, CJ ; Barnett, KJ ; MacLeod, J ; Humphry, RW ; Finlayson, D. / Does circumpatellar electrocautery improve the outcome after total knee replacement?. In: The Journal of Bone and Joint Surgery. 2012 ; Vol. 94. pp. 1228 - 1233.
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Baliga, S, McNair, CJ, Barnett, KJ, MacLeod, J, Humphry, RW & Finlayson, D 2012, 'Does circumpatellar electrocautery improve the outcome after total knee replacement?', The Journal of Bone and Joint Surgery, vol. 94, pp. 1228 - 1233.

Does circumpatellar electrocautery improve the outcome after total knee replacement? / Baliga, S; McNair, CJ; Barnett, KJ; MacLeod, J; Humphry, RW; Finlayson, D.

In: The Journal of Bone and Joint Surgery, Vol. 94, 2012, p. 1228 - 1233.

Research output: Contribution to journalArticle

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T1 - Does circumpatellar electrocautery improve the outcome after total knee replacement?

AU - Baliga, S

AU - McNair, CJ

AU - Barnett, KJ

AU - MacLeod, J

AU - Humphry, RW

AU - Finlayson, D

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N2 - The incidence of anterior knee pain following total knee replacement (TKR) is reported to be as high as 49%. The source of the pain is poorly understood but the soft tissues around the patella have been implicated. In theory circumferential electrocautery denervates the patella thereby reducing efferent pain signals. However, there is mixed evidence that this practice translates into improved outcomes. We aimed to investigate the clinical effect of intra-operative circumpatellar electrocautery in patients undergoing TKR using the LCS mobile bearing or Kinemax fixed bearing TKR. A total of 200 patients were randomised to receive either circumpatellar electrocautery (diathermy) or not (control). Patients were assessed by visual analogue scale (VAS) for anterior knee pain and Oxford knee score (OKS) pre-operatively and three months, six months and one year post-operatively. Patients and assessors were blinded. There were 91 patients in the diathermy group and 94 in the control. The mean VAS improvement at one year was 3.9 in both groups (control; -10 to 6, diathermy; -9 to 8, p < 0.001 in both cases, paired, two-tailed t-test). There was no significant difference in VAS between the groups at any other time. The mean OKS improvement was 17.7 points (0 to 34) in the intervention group and 16.6 (0 to 42) points in the control (p = 0.36). There was no significant difference between the two groups in OKS at any other time. We found no relevant effect of patellar electrocautery on either VAS anterior knee pain or OKS for patients undergoing LCS and Kinemax TKR.

AB - The incidence of anterior knee pain following total knee replacement (TKR) is reported to be as high as 49%. The source of the pain is poorly understood but the soft tissues around the patella have been implicated. In theory circumferential electrocautery denervates the patella thereby reducing efferent pain signals. However, there is mixed evidence that this practice translates into improved outcomes. We aimed to investigate the clinical effect of intra-operative circumpatellar electrocautery in patients undergoing TKR using the LCS mobile bearing or Kinemax fixed bearing TKR. A total of 200 patients were randomised to receive either circumpatellar electrocautery (diathermy) or not (control). Patients were assessed by visual analogue scale (VAS) for anterior knee pain and Oxford knee score (OKS) pre-operatively and three months, six months and one year post-operatively. Patients and assessors were blinded. There were 91 patients in the diathermy group and 94 in the control. The mean VAS improvement at one year was 3.9 in both groups (control; -10 to 6, diathermy; -9 to 8, p < 0.001 in both cases, paired, two-tailed t-test). There was no significant difference in VAS between the groups at any other time. The mean OKS improvement was 17.7 points (0 to 34) in the intervention group and 16.6 (0 to 42) points in the control (p = 0.36). There was no significant difference between the two groups in OKS at any other time. We found no relevant effect of patellar electrocautery on either VAS anterior knee pain or OKS for patients undergoing LCS and Kinemax TKR.

KW - Electrocautery

KW - Knee replacement

M3 - Article

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JO - The Journal of Bone and Joint Surgery

JF - The Journal of Bone and Joint Surgery

ER -