Staff Members - Benha University
Outcome of Arthroscopic Patellar Denervation in management of Patellofemoral Pain with Normal Patellar Alignment
• 2022
Publication Information
Authors
M.M.El Sayed, M.M.El Karamany, M.S.Singer, W.A.Omara
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publication.type
Local
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Abstract
Background: Patellofemoral pain syndrome (PFPS) is anterior knee pain that is increased by
ascending or descending stairs or prolonged sitting with bent knees in absence of significant structural
changes. It is common in females as well as young active adults. Anatomic factors such as increased
pelvic width and resulting in excessive lateral thrust on the patella, and postural and sociological
factors such as wearing high heels and sitting with legs adducted can influence the incidence and
severity of this condition in women. Conservative treatment is the first choice for dealing with
unspecified patellofemoral pain. Traditionally, conservative management of patellofemoral pain
involved pain-relieving techniques and standard quadriceps strengthening in non-weight-bearing
positions. Only, if a careful long-term physical therapy program has failed, one might consider surgery.
Pain treatment by denervation is not a new concept. The objective would be to interrupt the neural
pathways that transmit the pain message. It has been applied with good clinical results in trigeminal
neuralgia and some cases of intractable wrist pain. The current study aims to assess the outcome of
arthroscopic denervation of the patella using a radiofrequency ablation device in the management of
resistant patellofemoral pain in absence of malalignment and patellofemoral maltracking. Methods:
This prospective study was conducted in Orthopedic Surgery department at Benha University hospital.
This study was conducted on 25 patients with resistant patellofemoral pain syndrome. Results: In the
current study, we found that 72% of cases had chondromalacia grade 1 and 20% cases had
chondromalacia grade 2, also it was noticed that one case had flap tear posterior horn medial meniscus,
one case had medial plica, one case had MFC chondromalacia grade 1, one case had MFC
chondromalacia grade 2, one case had MFC ulcer and one case had medial meniscus horizontal tear.
Six months Post-operatively, there was high statistically significant improvement in pain VAS on
comparing preoperative (p
ascending or descending stairs or prolonged sitting with bent knees in absence of significant structural
changes. It is common in females as well as young active adults. Anatomic factors such as increased
pelvic width and resulting in excessive lateral thrust on the patella, and postural and sociological
factors such as wearing high heels and sitting with legs adducted can influence the incidence and
severity of this condition in women. Conservative treatment is the first choice for dealing with
unspecified patellofemoral pain. Traditionally, conservative management of patellofemoral pain
involved pain-relieving techniques and standard quadriceps strengthening in non-weight-bearing
positions. Only, if a careful long-term physical therapy program has failed, one might consider surgery.
Pain treatment by denervation is not a new concept. The objective would be to interrupt the neural
pathways that transmit the pain message. It has been applied with good clinical results in trigeminal
neuralgia and some cases of intractable wrist pain. The current study aims to assess the outcome of
arthroscopic denervation of the patella using a radiofrequency ablation device in the management of
resistant patellofemoral pain in absence of malalignment and patellofemoral maltracking. Methods:
This prospective study was conducted in Orthopedic Surgery department at Benha University hospital.
This study was conducted on 25 patients with resistant patellofemoral pain syndrome. Results: In the
current study, we found that 72% of cases had chondromalacia grade 1 and 20% cases had
chondromalacia grade 2, also it was noticed that one case had flap tear posterior horn medial meniscus,
one case had medial plica, one case had MFC chondromalacia grade 1, one case had MFC
chondromalacia grade 2, one case had MFC ulcer and one case had medial meniscus horizontal tear.
Six months Post-operatively, there was high statistically significant improvement in pain VAS on
comparing preoperative (p