title: [Denervation of the patella: influence on mid-term results after total knee arthroplasty].
abstract: BACKGROUND
  The purpose of the study was to determine possible differences in the mid-term results of total knee arthroplasty in patients treated with and without denervation of the patella.
  
  
  METHODS
  This study included 80 total knee replacements in 71 patients who were treated with total knee replacement, either with (n = 40) or without (n = 40) simultaneous denervation of the patella out of a total population with 122 knee replacements in 100 patients. Comparability of both groups was achieved by applying matching criteria. All patients were reviewed by isokinetic tests, physical and radiological examination. The mean follow-up time was 2.2 years.
  
  
  RESULTS
  The mean hospital for special surgery (HSS) score revealed no statistically significant differences between both groups (with denervation 77.9 ± 11.1 and without denervation 77.8 ± 11.0, p = 0.976). The isokinetic torque measurements with low angle velocity (60°/s) indicated slightly higher values during extension (60.2 ± 32.2 Nm versus 55.8 ± 25.2 Nm, p = 0.497) and flexion (52.4 ± 28.3 Nm versus 46.1 ± 22.3 Nm, p = 0.272) movements of the affected knee joint. However, the differences did not reach statistical significance. At high angle velocity (180°/s) no differences could be found between both groups. No cases of postoperative necrosis of the patella were observed. Anterior knee pain after denervation was reported in 6 cases (15 %) compared to 10 cases (25 %) in patients who were treated without denervation (p = 0.402).
  
  
  CONCLUSIONS
  No statistically significant differences could be found between patients with and without denervation of the patella for total knee arthroplasty.
authors.affiliation: Klinik für Orthopädie und Unfallchirurgie, Kliniken Calw, Eduard-Conz-Str. 6, 75365, Calw, Deutschland, m.handel@klinikverbund-suedwest.de.
authors.forename: M
authors.initials: M
authors.lastname: Handel
authors.forename: S
authors.initials: S
authors.lastname: Riedt
authors.forename: P
authors.initials: P
authors.lastname: Lechler
authors.forename: J
authors.initials: J
authors.lastname: Schaumburger
authors.forename: F X
authors.initials: FX
authors.lastname: Köck
authors.forename: S
authors.initials: S
authors.lastname: Sell
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D003714:Denervation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D010329:Patella / Q000294:innervation* / Q000601:surgery; D046788:Patellofemoral Pain Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D016059:Range of Motion, Articular; D016896:Treatment Outcome