Common Peroneal Nerve Palsy Following Total Knee Arthroplasty

Park, Jai Hyung; Restrepo, Camilo; Norton, Robert P.; Mandel, Steven; Sharkey, Peter F.; Parvızı, Javad

doi:10.1016/j.arth.2013.02.025

Cited by 59 publications

(75 citation statements)

References 24 publications

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“…3,8 Stretching of the soft tissue surrounding the nerve may lead to compression of the nerve or its vascular supply, resulting in neural ischemia. 3,9 Fortunately, nerve injury is an uncommon complication of TKA. However, the individuals who sustain these injuries may face substantial disability, and the limited improvement can be frustrating for the patient.…”

Section: Discussionmentioning

confidence: 99%

“…12 Other studies have postulated many other risk factors for nerve injury, including history of lumbar spine disease/lumbar spine surgery, peri-and postoperative anesthesia, tourniquet time, diabetes, rheumatoid arthritis, and blood loss. 3,4,9,16 Of these, only history of lumbar spine disease and length of anesthesia were identified as risk factors in our cohort of patients. Our results indicate that a history of lumbar spine disease/spinal stenosis or previous lumbar spine surgery may be a risk factor for foot-drop.…”

Section: Discussionmentioning

confidence: 99%

“…2 The incidence of nerve injury is inconsistent in the literature. 1,3 According to a more recent publication, the incidence of nerve injury after TKA ranges from 0.3% to 1.3%. 4 This variability can be attributed to a range of factors, including the specific prosthesis used, the size of the study population, and limitations on reporting of incidence.…”

mentioning

confidence: 99%

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Risk factors for acute nerve injury after total knee arthroplasty

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Risk factors for acute nerve injury after total knee arthroplasty

et al. 2018

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“…The risk of nerve palsy in association with total hip replacement is greater for women, patients with developmental dysplasia, and patients undergoing revision surgery. In addition, an increased risk of nerve palsy in association with total knee replacement is associated with valgus deformity, knee flexion contracture greater than 15 degrees, epidural anesthesia, pneumatic tourniquets, and revision surgery (Park et al, ).…”

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confidence: 99%

What Protects Certain Nerves from Stretch Injury?

Schraut

Walton

Monsef

et al. 2015

The Anatomical Record

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The human tibial nerves is less prone to injury following joint arthroplasty compared with the peroneal nerves. Besides the anatomical distribution, other features may confer protection from stretch injury. We therefore examined the size, shape and connective tissue distribution for the two nerves. The tibial and peroneal nerves from each side of nine fresh human cadavers we reharvested mid-thigh. Proximal segments manually stretched 20%-25% were fixed in aldehyde, while the adjacent distal segments were fixed in their natural length. Paraffin sections stained by Masson's trichrome method for connective tissue were examined by light microscopy. Tibial nerves had 2X more fascicles compared with the peroneal, but the axonal content appeared similar. Analysis showed that neither nerve had a significant reduction in cross sectional area of the fascicles following stretch. However, fascicles from stretched tibial nerves become significantly more oval compared with those from unstretched controls and peroneal nerves. Tibial nerves had a greater proportion that was extrafascicular tissue (50-55%) compared with peroneal nerves (38%-42%). This epineurium was typically adipose tissue. Perineurial thickness in both nerves was directly related to fascicular size. Tibial nerves have several unique histological features associated with size, shape and tissue composition compared with the peroneal nerve. We suggest that more fascicles with their tightly bound perineurium and more robust epineurium afford protection against stretch injury. Mechanical studies should clarify how size and shape contribute to nerve protection and/or neurapraxia. Anat Rec, 299:111-117, 2016. V C 2015 Wiley Periodicals, Inc.

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“…The use of MRI scan may provide visualization of the peripheral nerves and delineate the site of lesion 4. However, a lumbar spine MRI is definitely not the first‐line investigation that one should consider in the evaluation of peripheral neuropathy.…”

Section: Discussionmentioning

confidence: 99%