Denervation therapy for intractable pain of knee joint after total knee arthroplasty
10.3969/j.issn.2095-4344.2016.31.004
- VernacularTitle:去神经化治疗膝关节置换后膝关节顽固性疼痛
- Author:
Songhe MA
- Publication Type:Journal Article
- Keywords:
Arthroplasty,Replacement,Knee;
Dissection;
Denervation;
Tissue Engineering
- From:
Chinese Journal of Tissue Engineering Research
2016;20(31):4589-4595
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Anatomical studies on cutaneous nerve around the knee are less in China. Revision surgery or long-term use of medication is commonly used for intractable pain after knee replacement. However, these methods cannot effectively relieve postoperative pain. OBJECTIVE:To explore the therapeutic effect of denervation scheme on intractable pain in patients with knee joint pain after knee replacement through identifying the distribution of the cutaneous skin around the knee joint in the study of anatomy of the knee joint. METHODS:Two adult cadavers and two fresh adult cadavers were dissected to observe the distribution of cutaneous nerves around the knee joint. 100 cases of knee joint of patients with intractable pain after total knee arthroplasty were randomly divided into two groups (n=50). Patients in the observation group underwent denervation scheme. Patients in the control group underwent drug treatment. Patients were followed up after surgery. Bone joint index score was used to evaluate the knee joint function. 36-Item Short-Form Health Survey (SF-36) was utilized to evaluate the quality of life. Visual analogue scale was employed to assess the patient’s pain. Adverse reactions were recorded. RESULTS AND CONCLUSION:(1) Distribution of cutaneous nerves around the knee was fixed. Moreover, each cutaneous nerve had a more definite bony landmark, and could provide anatomic basis for related surgery. (2) Visual analogue scale scores were significantly lower in the observation group than in the control group (P<0.05). (3) Bone joint index score was lower, but SF-36 scores were higher in the observation group than in the control group at 1, 3, 6 and 12 months after surgery (P<0.05). (4) Three cases affected joint swel ing in the observation group and two cases suffered from joint swel ing in the control group. No significant difference in joint swel ing was detected between the two groups (P>0.05). (5) Necroscopy could identify anatomical distribution of cutaneous nerve around the knee. On this basis, denervation therapy can effectively improve symptoms and bone quality in patients with intractable pain, improve the quality of life of patients, and have better safety.
