title: Circumferential electrocautery of the patella in primary total knee replacement without patellar replacement: a meta-analysis and systematic review.
abstract: The purpose of this meta-analysis and systematic review was to identify and assess whether circumferential electrocautery is useful for improving outcomes after primary total knee replacement(TKR). We searched MEDLINE, EMBASE, PubMed, SpringerLink, Web of Knowledge, OVID CINAHL, OVID EBM and Google Scholar and included articles published through January 2014. A total of 6 articles met the inclusion criteria. Of the 776 cases included in the analysis, 388 cases involved patellar denervation, and 388 cases were designated as the control group. The meta-analysis revealed no significant difference in the incidence of anterior knee pain (AKP, p = 0.18) or in the visual analogue scale score (VAS, p = 0.23) between the two groups. In addition, AKSS Function Score indicated no significant difference between the two groups (p = 0.28). However, the OKS (p = 0.02), patellar score (p = 0.01), AKSS-Knee Score (p = 0.004), range of motion (ROM, p < 0.0001) and WOMAC Score (p = 0.0003) indicated that circumpatellarelectrocautery improved clinical outcomes compared with non-electrocautery. The results indicate that circumferential electrocautery of the patella does not significantly improve AKP compared with non-electrocautery techniques but that circumferential electrocautery significantly improves patients' knee function after surgery. Therefore, we believe that circumferential electrocautery is beneficial to the outcome of primary TKR surgery without patellar replacement.
authors: Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwu Road, Xi'an, Shaanxi 710004, China.
authors: Lihong
authors: L
authors: Fan
authors: Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwu Road, Xi'an, Shaanxi 710004, China.
authors: Zhaogang
authors: Z
authors: Ge
authors: Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwu Road, Xi'an, Shaanxi 710004, China.
authors: Chen
authors: C
authors: Zhang
authors: Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwu Road, Xi'an, Shaanxi 710004, China.
authors: Jia
authors: J
authors: Li
authors: Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwu Road, Xi'an, Shaanxi 710004, China.
authors: Zefeng
authors: Z
authors: Yu
authors: Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwu Road, Xi'an, Shaanxi 710004, China.
authors: Xiaoqian
authors: X
authors: Dang
authors: Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwu Road, Xi'an, Shaanxi 710004, China.
authors: Kunzheng
authors: K
authors: Wang
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D003714:Denervation / Q000379:methods; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000294:innervation / Q000473:pathology / Q000601:surgery*; D008297:Male; D020370:Osteoarthritis, Knee / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D010149:Postoperative Pain / Q000517:prevention & control; D010329:Patella / Q000294:innervation / Q000473:pathology / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome