Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China,
Knee Surg Sports Traumatol Arthrosc. 2014 Nov;22(11):2648-54. doi: 10.1007/s00167-013-2533-9. Epub 2013 Jun 7.
The impact of patellar denervation with electrocautery in total knee arthroplasty (TKA) on post-operative outcomes has been under debate. This study aims to conduct a meta-analysis and systematic review to compare the benefits and risks of circumpatellar electrocautery with those of non-electrocautery in primary TKAs.
Comparative and randomized clinical studies were identified by conducting an electronic search of articles dated up to September 2012 in PubMed, EMBASE, Scopus, and the Cochrane databases. Six studies that focus on a total of 849 knees were analysed. A random-effects model was conducted using the inverse-variance method for continuous variables and the Mantel-Haenszel method for dichotomous variables.
There was no significant difference in the incidence of anterior knee pain between the electrocautery and non-electrocautery groups. In term of patellar score and Knee Society Score, circumpatellar electrocautery improved clinical outcomes compared with non-electrocautery in TKAs. The statistical differences were in favour of the electrocautery group but have minimal clinical significance. In addition, the overall complications indicate no statistical significance between the two groups.
This study shows no strong evidence either for or against electrocautery compared with non-electrocautery in TKAs.
Therapeutic study (systematic review and meta-analysis), Level III.
在全膝关节置换术（TKA）中用电灼法进行髌骨去神经支配的影响一直存在争议。本研究旨在进行荟萃分析和系统评价，以比较原发性 TKA 中环髌骨电灼与非电灼的益处和风险。
通过对 PubMed、EMBASE、Scopus 和 Cochrane 数据库中截至 2012 年 9 月的文章进行电子检索，确定了比较性和随机对照临床试验。分析了 6 项共涉及 849 例膝关节的研究。对于连续变量采用倒数方差法进行随机效应模型，对于二分类变量采用 Mantel-Haenszel 法。
电灼组和非电灼组在前膝痛的发生率方面无显著差异。在髌骨评分和膝关节协会评分方面，与非电灼相比，环髌骨电灼可改善 TKA 的临床结果。统计学差异有利于电灼组，但具有最小的临床意义。此外，两组之间的总体并发症无统计学意义。
本研究表明，在 TKA 中，电灼与非电灼相比，没有强有力的证据支持或反对。
治疗性研究（系统评价和荟萃分析），III 级。
