Osteoarthritis, Knee
Conditions
Keywords
Total knee arthroplasty, Electrocautery, Scalpel, Post-operative pain, Pain score
Brief summary
Total knee arthroplasty (TKA) is a successful treatment for end-stage osteoarthritis of the knee. The main advantages of TKA are to relieve the pain of the knee, improve the knee function, restore lower limb alignment, and improve the quality of life for patients. During TKA, some surgeons prefer using a scalpel while others using electrocautery to expose the articular cavity. Whether the use of scalpel can lead to better and faster recovery after the primary TKA is still controversial. The aim of this study was to compare the clinical outcomes of using the scalpel and the electrocautery in primary TKA
Detailed description
A randomized controlled trial of patients underwent primary TKA between October 2021 and October 2023. The groups will be determined by using the computer to generate a randomization lists. A total 132 patients were included with 66 patients in the scalpel group, 66 patients in the electrocautery group. All patients were evaluated using primary outcome : Post-operative Visual Analog Scale (VAS) of pain, secondary outcome: estimated blood loss and Knee Injury and Osteoarthritis Outcome Score (KOOS-JR)
Interventions
PROCEDUREtotal knee arthroplasty
total knee arthroplasty surgery with Police Arthroplasty joint academy center(PAJAC) Subvastus Approach
Sponsors
Police General Hospital, Thailand
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Intervention model description
In electrocautery group, using an electrocautery in following step 1. Stop bleeding at subcutaneous tissue layer 2. Remove anterior cruciate ligament and posterior cruciate ligament 3. Bony mark for further bone cut 4. Patellar denervation 5. Soft tissue removal 6. Synovial tissue removal In scalpel group, proceed with following step 1. Using electrocautery for stop bleeding at subcutaneous tissue layer 2. In deep layer still use scalpel for Remove anterior cruciate ligament and posterior cruciate ligament 3. Soft tissue removal and synovial tissue removal 4. No patellar denervation
Eligibility
Sex/Gender
ALL
Age
58 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Osteoarthritis patient (KL classification gr 2-4) * Primary TKA * Varus deformity \< 20 degree * Flexion contracture \< 20 degree
Exclusion criteria
* Coagulopathy * Platelet dysfunction * Inflammatory arthritis * Revision TKA
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain (visual analog scale) day 1-4 | postoperative day 1-4 | measure the Postoperative pain by using visual analog scale from 1 - 10, higher scores means worse outcome |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Calculated blood loss | postoperative day 4 | Calculated blood loss using Mercuruali's formula |
| Functional score | follow up 2 weeks, 1,3,6 months | Functional score using KOOS JR score, range from 0 to 100 with a score of 0 indicating total knee disability and 100 indicating perfect knee health |
Countries
Thailand
Outcome results
None listed