Nerve injury after primary total knee arthroplasty

• Published in: The Journal of arthroplasty Vol. 16; no. 8; pp. 1048 - 1054
• Main Authors: Schinsky, Mark F., Macaulay, William, Parks, Michael L., Kiernan, Howard, Nercessian, Ohannes A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2001
• Subjects: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee - adverse effects; complications; Female; Humans; Incidence; Knee Prosthesis - adverse effects; Male; Middle Aged; neurologic injury; palsy; Paralysis - epidemiology; Paralysis - etiology; Peripheral Nervous System Diseases - epidemiology; Peripheral Nervous System Diseases - etiology; peroneal nerve; Peroneal Nerve - injuries; Postoperative Complications - epidemiology; Postoperative Complications - etiology; primary; Retrospective Studies; Risk Factors; total knee arthroplasty; total knee arthroplasty; palsy; neurologic injury; complications; peroneal nerve; primary
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1054/arth.2001.26591

There is controversy about the incidence of and predisposing factors to the development of peripheral nerve palsy after total knee arthroplasty (TKA). In this study, 19 patients with a documented neurologic complication were identified after a retrospective review of 1,476 primary TKAs performed between January 1970 and December 1998 at the New York Presbyterian Hospital at Columbia University, for an overall incidence of 1.3%. Contrary to previously published data, valgus deformity, flexion contracture, the use of postoperative epidural anesthesia, the prolonged use of pneumatic tourniquets, and preexisting neuropathy were not associated with the development of peripheral neuropathy after TKA based on our data. A larger percentage of rheumatoid knees experienced a neurologic injury than was expected, however. No other significant risk factors for peripheral neuropathy after TKA were identified based on data from our patients. Immediately after discovery of the nerve palsy, conservative treatment was employed for each of our patients. All patients showed at least a partial recovery at the end of follow-up, with most experiencing a complete recovery from symptoms.