PARTIAL DENERVATION FOR PERSISTENT NEUROMA PAIN AFTER TOTAL KNEE ARTHROPLASTY

被引:0
作者
DELLON, AL
MONT, MA
KRACKOW, KA
HUNGERFORD, DS
机构
[1] JOHNS HOPKINS UNIV, DIV PLAST SURG, BALTIMORE, MD USA
[2] JOHNS HOPKINS UNIV, DEPT NEUROL SURG, BALTIMORE, MD USA
[3] JOHNS HOPKINS UNIV, HOSP GOOD SAMARITAN,SCH MED,DEPT ORTHOPAED SURG, DIV ARTHRITIS SURG, BALTIMORE, MD USA
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中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Despite the high percentage of patients who are satisfied completely with Mle results of total knee arthroplasty, there is a small group who remain disabled because of persistent neuroma pain, Recently, a better understanding of the innervation of the skin and capsule around the human knee joint has provided a theoretical basis for denervation in this group of patients, Fifteen patients were identified who had persistent or worse knee pain for >6 months after total knee arthroplasty, In each patient, component loosening, malalignment, knee instability, and infection had been excluded systematically as a source of pain, Pain was evaluated preoperatively with the Knee Society Functional Score Questionnaire and a visual analog scale, To be selected for surgery, each patient must have had a reduction by 5 points on the visual analogue scale for pain after undergoing selective nerve blocks, Postoperative assessment was done by a team that did not include the surgeon who did the denervation, The technique for selective knee denervation is described in detail, All 15 patients had at least 1 of the nerves to the knee selectively denervated (45 nerves in 15 patients). All patients reported subjective improvement in the immediate postoperative period, This improvement was maintained Id a mean followup of 12 months (range, 6-16 months). Selective knee denervation is indicated in the management of intractable knee pain of neuroma origin after total knee arthroplasty.
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页码:145 / 150
页数:6
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