Abstract
Purpose: This study was carried out to compare the alteration in skin sensation following midline, medial and short medial incisions for knee replacement.
Method: 88 patients with 102 replaced knees were examined for altered skin sensation over the front of the knee, all were at least 18 months from their knee replacement. Twenty-one knees had a medial incision, 38 a midline incision and 43 a short medial incision for UKR.
A scale of −2 to +2 was used to measure different degrees of skin hypo or hyperaesthia. A purpose-designed grid, designed to fit different knee sizes, was used to record sensations. A computer programme was created to record all patients’ data including the length and shape of the incision in relation to anatomical landmarks.
A parallel histological study was carried out on 18 skin specimens taken from the 2 standard incisions. The specimens were prepared and stained for nerve endings. The number of nerve endings in each incision was calculated.
Results Histologically, less cutaneous nerve endings were seen in specimens from midline incisions than medial incisions.
Discussion: Altered skin sensation is unpleasant to many patients at least initially and may affect function especially kneeling. The midline line incision seems to produce less dermal parasthesia than the medial incision, this probably relates to both the wound position and the density of nerve endings. As expected, the length of incision correlated with the area of numbness when comparing short and long medial incisions.
Honorary Secretary – Mr Roger Smith. Correspondence should be addressed to BASK at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN
