Denervation around patella in the total knee arthroplasty of diabetic patients

doi:10.3877/cma.j.issn.1674-134X.2020.02.003

Abstract

Abstract:

Objective

To explore the effect and influence of patella denervation on diabetic patients undergoing total knee arthroplasty(TKA).

Methods

A prospective analysis of the patients undergoing TKA was carried out in Xinjiang Traditional Chinese Medicine Hospital from January 2012 to December 2015. Inclusion criteria: severe knee osteoarthritis, unilateral TKA, T2DM, use insulin to control blood sugar perioperative, blood sugar level is satisfactory and preoperative glycated hemoglobin (HbA1c) is 4% to 6%, agreed to participate in the study. Exclusion criteria: patellar surface replacement, previous lower limb fracture deformity healing, previous history of immune system diseases, blood system diseases, mental diseases, unable to cooperate with functional exercise.According to the inclusion and exclusion criteria, a total of 88 subjects were included in the study. Patients were randomly included in the denervation group of 38 people and non-denervation group of 50 people according to whether or not to perform denervation around the patella. The t test was used to compare the American Knee Society (AKS) scoring system, Feller patellofemoral joint score, and visual analog score (VAS) at three and six months postoperatively. The healing of surgical incisionwas recorded.

Results

At three months and six months after surgery, the AKS knee grade (t =16.474, 7.452), AKS knee function (t =7.906, 1.484), Feller score (t=13.999, 13.583), VAS score (t=-10.903, -3.609)were better than the non-denervation group, the difference is statistically significant (all P<0.05). The same indicators of patients at three months and six months after operation were compared with themselves, AKS knee joint grade (t=25.506, P<0.05), AKS knee joint function (t=19.173, P<0.05), Feller score ( t =11.873, P<0.05), VAS score (t=-10.344, P<0.05) improved with time, the differences were statistically significant.Three patients (7.9%) in the denervation group had postoperative surgical incision redness, which occurred on the third, third, and fifth day after surgery respectively. Four patients (8.0%) in the non-denervation group had surgical incision redness and occurred on the second, third, third, and third day after operation, respectively, and one patient (2.0%) had slight fat liquefaction. None of the patients experienced delayed healing, cracking, or infection of the surgical incision.

Conclusion

Diabetic patients undergoing denervation around the patella during TKA surgery can improve short-term knee function, reduce anterior knee pain, and will not cause increased surgical incision complications.

Key words: Arthroplasty, replacement, knee, Patella, Denervation, Recovery of function, Pain, postoperative

Yu Si, Rehemutula Aierken, Hongyu Zhou, Li Li. Denervation around patella in the total knee arthroplasty of diabetic patients[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(02): 144-148.

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References 20

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分组	例数	性别(男/女)	年龄[岁，(±s)]	术前WOMAC评分(±s)	术前HbA1c[%，(±s)]
去神经化组	38	17/21	70.2±7.0	76.1±9.0	5.2±0.3
非去神经化组	50	18/32	71.5±6.0	74.3±7.0	5.1±0.3
统计值		χ²＝0.688	t＝－1.245	t＝1.257	t＝1.504
P值		>0.05	>0.05	>0.05	>0.05

分组	例数	性别(男/女)	年龄[岁，(±s)]	术前WOMAC评分(±s)	术前HbA1c[%，(±s)]
去神经化组	38	17/21	70.2±7.0	76.1±9.0	5.2±0.3
非去神经化组	50	18/32	71.5±6.0	74.3±7.0	5.1±0.3
统计值		χ²＝0.688	t＝－1.245	t＝1.257	t＝1.504
P值		>0.05	>0.05	>0.05	>0.05

分组	例数	AKS膝关节分级	AKS膝关节功能	Feller评分	VAS评分
去神经化组	38	67.6±4.6	62.7±4.3	24.7±2.5	3.1±0.9
非去神经化组	50	51.5±4.5	56.0±3.7	18.2±1.9	5.3±1.1
t值		16.474	7.906	13.999	－10.903
P值		<0.05	<0.05	<0.05	<0.05

分组	例数	AKS膝关节分级	AKS膝关节功能	Feller评分	VAS评分
去神经化组	38	67.6±4.6	62.7±4.3	24.7±2.5	3.1±0.9
非去神经化组	50	51.5±4.5	56.0±3.7	18.2±1.9	5.3±1.1
t值		16.474	7.906	13.999	－10.903
P值		<0.05	<0.05	<0.05	<0.05

分组	例数	AKS膝关节分级	AKS膝关节功能	Feller评分	VAS评分
去神经化组	38	85.0±4.6	71.0±2.8	27.7±2.0	2.1±1.0
非去神经化组	50	76.0±6.7	70.1±3.0	22.5±1.6	2.9±1.1
t值		7.452	1.484	13.583	－3.609
P值		<0.05	<0.05	<0.05	<0.05

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