Patella Denervation improves patient satisfaction following TKA


Patella Denervation in Primary Total Knee Arthroplasty – A Randomized Controlled Trial with 2 Years of Follow-Up

Ramnadh S. Pulavarti, Videsh V. Raut, George J. McLauchlan

Department of Orthopaedics and Trauma, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley and South Ribble Hospital, Chorley, Lancashire, United Kingdom


The Journal of Arthroplasty Volume 29, Issue 5, Pages 977–981, May 2014joa

Level 1 Randomized Control Trial

Materials and Methods


  • 126 patients scheduled to undergo primary TKA due to osteoarthritis were included in the study.
  • Surgery was standardized in all patients- a midline incision and medial parapatellar approach was used , and cruciate retaining implants were used.
  • Postoperative physiotherapy protocol was similar in all groups

INTERVENTION- Denervation Group: 63 patients

  • This group of patients underwent a standard TKA procedure and received denervation of the patella using monopolar coagulation diathermy (valleylab inc.,Boulder,CO) set 50 W.
  • DVT Prophylaxis included- LMW heparin injection, which was continued until patients were fully mobile and discharged from care (Mean age:69.9, 31M/32F)

COMPARISON- Control group: 63 patients

  • Patient in this group underwent a standard TKA procedure with no denervation of the patella (Mean age:69.8)
  • 58 patients completed follow up, there were 27M/36F


  • Outcomes measurements used: Patient satisfaction, Oxford Knee Score(OKS), Knee Society score(KSS) and Knee Society Function score, patellar score, activities of Daily Living(ADL), VAS for anterior knee pain , and UCLA score

METHODS-RCT: single center, Double Blind

Duration: 24 months(Follow –up scheduled for 2, 12, and 24 months postoperatively).


  • Pain scores for anterior knee pain, patella scores were significantly better in the denervation group at 3 months but not at 12 and 24 months.
  • Patient satisfaction was higher in the denervation group.
  • Flexion range was higher in the denervation group at 3, 12 and 24 months review (P<0.01).
  • There were, however, no statistically significant differences with other validated knee scores.


  • Patellar denervation is a simple procedure in TKA with improved patient satisfaction, although it is not associated with significant improvement in validated knee outcomes.  It is not associated with any significant complications




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