Abstract
PurposePatellofemoral (PF) joint osteoarthritis (OA) is a major cause of anterior knee pain. Combined PF and medial tibiofemoral (TF) OA is common in older adults. We evaluated the effect of arthroscopic patellar denervation (PD) in patients with combined TF and PFOA after malalignment correction.MethodsForty-five patients [females/males, 27/18; age, 30–59 years (45.5 ± 8.50); mean body mass index, 25.15 ± 3.04 kg/m2] were treated in our department from March 2017 to March 2019. The patients were randomised into 2 groups: group A included 22 patients who underwent open-wedge high tibial osteotomy (OWHTO) and arthroscopic PD and group B included 23 patients who underwent OWHTO without denervation. The effect of denervation was statistically and clinically evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS) and Kujala (anterior knee pain score) score.ResultsAfter 24 months, 40 patients were available for the final follow-up. The final values of KOOS and the Kujala score were significantly different between the groups (p < 0.001). For group A, the average KOOS improved from 42.73 to 72.38 (p < 0.001) and the Kujala score improved from 42 to 74.1 (p < 0.001), whereas in group B, the average KOOS improved from 39.22 to 56.84 (p < 0.001) and the Kujala score improved from 39.7 to 56.4 (p < 0.001).ConclusionAdding arthroscopic PD to OWHTO relieves anterior knee pain in patients with combined TF and PFOA and improves knee joint function and quality of life.Level of evidenceLevel I prospective randomised control clinical trial.
Highlights
Patellofemoral (PF) osteoarthritis (OA) is a highly prevalent disease and an important cause of anterior knee pain
The main finding of the present study was that arthroscopic patellar denervation (PD) improves anterior knee pain, and this technique should be considered in patients with combined medial TF and PFOA undergoing open-wedge high tibial osteotomy (OWHTO)
This study demonstrated that PD decreases short-term anterior knee pain in patients with PFOA undergoing unicompartmental knee arthroplasty (UKA)
Summary
Patellofemoral (PF) osteoarthritis (OA) is a highly prevalent disease and an important cause of anterior knee pain. It greatly affects several daily activities, including kneeling, squatting, climbing stairs and getting up from a low chair [20, 22]. Boling et al [5] demonstrated that anterior knee pain primarily affects middle-aged people and is 2.23fold more common in females than males (our random sample size is consistent with these findings; 24 females and 16 males) [12]. Knee pain and disability are more severe in combined PF and TFOA, which is a common presentation in older adults [17].
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