|dc.description.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
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.||