Mistry Dinshaw, O'Meeghan Christopher
Department of Orthopaedics, Waikato Hospital, Hamilton, New Zealand.
ANZ J Surg. 2005 Sep;75(9):822-4. doi: 10.1111/j.1445-2197.2005.03532.x.
The infrapatellar branch of the saphenous nerve is a known cause of morbidity following knee surgery. The incidence of sensory changes following total knee arthroplasty, and its effect on patient satisfaction with arthroplasty surgery remain undocumented. Our aim was to document the incidence of infrapatellar nerve palsy following total knee arthroplasty and its effect on patient satisfaction.
Between 1 January 2002 and 31 December 2003 all patients attending outpatients clinic for primary total knee joint arthroplasty were prospectively tested for sensory defects. Patients were then assessed postoperatively and satisfaction was measured using the British Orthopaedic Satisfaction Score and a visual analogue scale.
Thirty-one patients satisfied inclusion criteria of which 21 agreed to participate. One patient was excluded later in the study leaving 20 patients. Seventy per cent of patients had sensory changes in the area supplied by the infrapatellar branch of the saphenous nerve. Patient satisfaction scores did not correlate to the presence of a sensory deficit. Two patients stated that the sensory deficit was a significant factor in their dissatisfaction with their arthroplasty surgery.
Sensory changes due to damage to the infrapatellar branch of the saphenous nerve during total knee joint arthroplasty is a common occurrence and can interfere with patient satisfaction. Patients should be informed of this risk in the preoperative discussion.
隐神经髌下支是膝关节手术后发病的已知原因。全膝关节置换术后感觉改变的发生率及其对患者关节置换手术满意度的影响尚无文献记载。我们的目的是记录全膝关节置换术后髌下神经麻痹的发生率及其对患者满意度的影响。
在2002年1月1日至2003年12月31日期间，对所有到门诊接受初次全膝关节置换术的患者进行前瞻性感觉缺陷检测。然后对患者进行术后评估，并使用英国骨科满意度评分和视觉模拟量表测量满意度。
31例患者符合纳入标准，其中21例同意参与。1例患者在研究后期被排除，剩余20例患者。70%的患者在隐神经髌下支所支配区域出现感觉改变。患者满意度评分与感觉缺陷的存在无关。2例患者表示感觉缺陷是他们对关节置换手术不满意的重要因素。
全膝关节置换术中隐神经髌下支损伤导致的感觉改变很常见，可能会影响患者满意度。在术前讨论中应告知患者这种风险。
