Does Electrocautery Increase Postoperative Pain in Primary Total Knee Arthroplasty

Police General Hospital, Thailand

Status and phase: Active, not recruiting; Phase 3

Conditions: Osteoarthritis, Knee

Treatments: Procedure: total knee arthroplasty

Study type: Interventional

Funder types: Other

Identifiers

NCT06239038

PGH protocal

Details and patient eligibility

About

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

Full 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)

Enrollment: 132 estimated patients

Sex: All

Ages: 58+ years old

Volunteers: Accepts Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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132 participants in 2 patient groups

scalpel group

Experimental group

Description:

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

Treatment:

Procedure: total knee arthroplasty

electrocautery group

Experimental group

Description:

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

Treatment:

Procedure: total knee arthroplasty