Circumferential electrocautery of the patellar in primary total knee replacement without patella replacement: a meta-analysis and systematic review

Abstract

Objective To identify and assess whether circumferential electrocautery is useful to improve outcomes after primary total knee replacement. Methods We searched MEDLINE, EMBASE, PubMed, SpringerLink, Web of Knowledge, OVID CINAHL, OVID EBM and Google Scholar, and included articles published through January 2014. This study used the methods of meta-analysis to assess whether circumferential electrocautery could improve anterior knee pain and knee function after total knee replacement, and identified the function of circumferential electrocautery in total knee replacement. Results A total of eight articles met the inclusion criteria. Among the 1 048 cases included in the analysis, 526 cases had patellar denervation, and 522 cases were in the control group. The meta-analysis revealed no significant difference in the incidence of anterior knee pain (P=0.18) and visual analogue scale (VAS) (P=0.23) between two groups. However, patellar score (P=0.01), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score (P<0.01), and range of motion (ROM) (P<0.01) indicated that circumpatellar electrocautery improved clinical outcomes compared to non-electrocautery groups. Conclusions The results indicated that circumferential electrocautery of the patellar did not significantly improve anterior knee pain relative to non-electrocautery techniques. However, circumferential electrocautery significantly improved patients' knee function after surgery. Therefore, circumferential electrocautery might be beneficial to the outcome of primary total knee replacement surgery without patella replacement. Key words: Patella; Denervation; Arthroplasty, replacement, knee; Meta-analysis