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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2012

01-10-2012 | Knee

Alteration in skin sensation following knee arthroplasty and its impact on kneeling ability: a comparison of three common surgical incisions

Authors: Mo Hassaballa, Neil Artz, Adrian Weale, Andrew Porteous

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2012

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Abstract

Purpose

Disturbance in skin sensation is a recognised, often unpleasant consequence of knee replacement for many patients and may affect function especially kneeling. The aim of this study was to compare post-operative changes in skin sensation following total (TKA) and unicompartmental knee (UKA) arthroplasties using three different incision types and its effect on kneeling ability.

Methods

Skin sensation was recorded using a purpose-designed grid over the front of the knee in 72 patients (78 knees) following knee arthroplasty. Surface area of sensory change, length of incision, and kneeling ability were recorded and compared between three different types of incision; long antero-medial and midline for TKA, and short medial for UKA.

Results

The average length of the long antero-medial incision was 19 ± 5 cm with an average area of sensory alteration of 88 ± 56 cm2. The average length of the midline incision was 18 ± 3 cm with an average area of sensory alteration of 57 ± 52 cm2. The short medial incision used for UKA averaged 11 ± 3 cm in length with an average area of sensory alteration of 54 ± 45 cm2. Long antero-medial produced a significantly greater area of sensory alteration than standard short medial (P = 0.017), but not the midline incision. There was a significant positive correlation of incision length with reduced sensation. Patients unable to kneel demonstrated a significantly larger area of hypersensitivity than patients who could kneel (P = 0.002).

Conclusions

Increased length of incision results in a greater surface area of sensory change in the front of the knee. This finding was greatest in the long antero-medial incisions used in TKA. The inability to kneel following knee arthroplasty is associated with increased area of hypersensitivity of the anterior knee.

Level of evidence

Prospective comparative study, Level II.
Literature
1.
Baccarani G, Zanotti G (1984) The innervation of the skin on the antero-medial region of the knee. Ital J Orthop Traumatol 10:521–525PubMed
2.
Berg P, Mjoberg B (1991) A lateral skin incision reduces peripateller dyaesthesias after knee surgery. J Bone Jt Surg [Br] 73-B:374–376
3.
Borley NR, Edwards D, Villar RN (1995) Lateral skin flap numbness after total knee arthroplasty. J Arthroplasty 10:13–14PubMed
4.
Ebraheim NA, Mekhail AO (1997) The infrapatellar branch of the saphenous nerve: an anatomic study. J Orthop Trauma 11:195–199PubMedCrossRef
5.
Hassaballa MA, Porteous AJ, Newman JH (2004) Observed kneeling ability after total, unicompartmental and patellofemoral knee arthroplasty: perception versus reality. Knee Surg Sports Traumatol Arthrosc 12:136–139PubMedCrossRef
6.
Hopton BP, Tommichan MC, Howell FR (2004) Reducing lateral skin flap numbness after total knee replacement. Knee 11:289–291PubMedCrossRef
7.
Jenkins C, Barker KL, Pandit H, Dodd CAF, Murray DW (2008) After partial knee replacement, patients can kneel, but they need to be taught to do so: a single-blind randomized controlled trial. Phys Ther 88:1012–1021PubMedCrossRef
8.
Johnson DF, Love DT, Love BR, Lester DK (2000) Dermal hypoesthesia after total knee arthroplasty. Am J Orthop 29:863–866PubMed
9.
McMinn RMH (ed) Last’s anatomy: regional and applied, 8th edn. Churchill Livingstone, Edinburgh, pp 184–212
10.
Müller W (1983) The knee: form, function, and ligament reconstruction. Springer, Heidelberg, pp 161–162
11.
Schai PA, Gibbon AJ, Scott RD (1999) Kneeling ability after total knee arthroplasty: perception and reality. CORR 367:195–200
12.
Song MH, Kim BH, Ahn SJ, Yoo SH, Shin SH (2010) Preventing lateral skin numbness after medial unicompartmental knee arthroplasty. Clin Orthop Surg 2:232–236PubMedCrossRef
13.
Subramanian S, Lateef H, Massraf A (2009) Cutaneous sensory loss following primary total knee arthroplasty. A 2 years follow-up study. Acta Orthop Belg 75:649–653PubMed
14.
Tifford CD, Spero L, Luke T, Plancher KD (2000) The relationship of the infrapatellar branches of the saphenous nerve to arthroscopy portals and incisions for anterior cruciate ligament surgery. An anatomic study. Am J Sports Med 28:562–567PubMed
15.
Williams D, Warwick D, Dyson M, Bannister L (1989) Grays anatomy, 37th edn. Churchill-Livingstone, New York, p 1143
Metadata
Title
Alteration in skin sensation following knee arthroplasty and its impact on kneeling ability: a comparison of three common surgical incisions
Authors
Mo Hassaballa
Neil Artz
Adrian Weale
Andrew Porteous
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2012
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1727-2

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