RESEARCH ARTICLE


A Dutch Survey on Circumpatellar Electrocautery in Total Knee Arthroplasty



Hans-Peter W. van Jonbergen*, 1, Alexander F.W. Barnaart1, Cees C.P.M. Verheyen2
1 Department of Orthopedic Surgery, Deventer Hospital, P.O. Box 5001, 7400 GC Deventer, The Netherlands
2 Department of Orthopedic Surgery and Traumatology, Isala Clinics, P.O. Box 10500, 8000 GM Zwolle, The Netherlands


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Creative Commons License
© van Jonbergen et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Orthopedic Surgery, Deventer Hospital, P.O. Box 5001, 7400 GC Deventer, The Netherlands; Tel: +31 570 535155; Fax: +31 570 501431; E-mail: vanjonbergen@dz.nl


Abstract

Introduction:

Anterior knee pain following total knee arthroplasty is estimated to occur in 4-49% of patients. Some orthopedic surgeons use circumpatellar electrocautery (diathermy) to reduce the prevalence of postsurgical anterior knee pain; however, the extent of its use is unknown.

Materials and Methodology:

In April 2009, a postal questionnaire was sent to all 98 departments of orthopedic surgery in The Netherlands. The questions focused on the frequency of total knee arthroplasties, patellar resurfacing, and the use of circumpatellar electrocautery.

Results:

The response rate was 92%. A total of 18,876 TKAs, 2,096 unicompartmental knee arthroplasties, and 215 patellofemoral arthroplasties are performed yearly in The Netherlands by the responding orthopedic surgeons. Of the orthopedic surgeons performing TKA, 13% always use patellar resurfacing in total knee arthroplasty for osteoarthritis, 49% use selective patellar resurfacing, and 38% never use it. Fifty-six percent of orthopedic surgeons use circumpatellar electrocautery when not resurfacing the patella, and 32% use electrocautery when resurfacing the patella.

Conclusion:

There is no consensus among Dutch orthopedic surgeons on the use of patellar resurfacing or circumpatellar electrocautery in total knee replacement performed for osteoarthritis. A prospective clinical trial is currently underway to fully evaluate the effect of circumpatellar electrocautery on the prevalence of anterior knee pain following total knee arthroplasty.

Keywords: Knee osteoarthritis, arthroplasty, patella, health care surveys, electrocoagulation, diathermy.