Nerve injury after primary total knee arthroplasty

Schinsky, Mark F.; Macaulay, William; Parks, Michael L.; Kiernan, Howard A.; Nercessian, Ohannes A.

doi:10.1054/arth.2001.26591

Cited by 115 publications

(78 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the literature different main complications have been described [2]: [37,38] Correction of a valgus deformity places the peroneal nerve at risk for indirect injury via traction, ischaemia or both. Apart from indirect mechanisms, concern has been expressed over the use of the Ranawat inside-out release, which may place the nerve at risk for direct laceration-type injuries.…”

Section: Complicationsmentioning

confidence: 99%

Total knee arthroplasty in the valgus knee

Rossi¹,

Rosso

Cottino

et al. 2013

International Orthopaedics (SICOT)

131

136

View full text Add to dashboard Cite

Valgus knee deformity is a challenge in total knee arthroplasty (TKA) and it is observed in nearly 10 % of patients undergoing TKA. The valgus deformity is sustained by anatomical variations divided into bone remodelling and soft tissue contraction/elongation. Bone tissue variations consist of lateral cartilage erosion, lateral condylar hypoplasia and metaphyseal femur and tibial plateau remodelling. Soft tissue variations are represented by tightening of lateral structures: lateral collateral ligament, posterolateral capsule, popliteus tendon, hamstring tendons, the lateral head of the gastrocnemius and iliotibial band. Complete pre-operative planning and clinical examination are mandatory to manage bone deformities and soft tissue contractions/elongations and to decide if a higher constrained prosthesis is necessary. Two different approaches have been described to perform TKA in a valgus knee: the anteromedial approach and the anterolateral one. In valgus knee deformity bone cuts can be performed differently in order to correct low-grade deformities and reduce great deformities. There is still debate in the literature on the sequence of lateral soft tissue release to achieve the best alignment without any instability. The aim of this article is to review the anatomical variations underlying a valgus knee, to assess the best pre-operative planning and to evaluate how to choose the grade of constraint of the implant. We will also review the main approaches and surgical techniques both for bone cuts and soft tissue management. Finally, we will report on our experience and technique.

show abstract

Section: Complicationsmentioning

confidence: 99%

Total knee arthroplasty in the valgus knee

Rossi¹,

Rosso

Cottino

et al. 2013

International Orthopaedics (SICOT)

131

136

View full text Add to dashboard Cite

show abstract

“…Paralysis of the fibular nerve are more frequent in knees with valgus deviation, as upon correction of the axis, by section of capsular, tendon and ligament structures, the nerve can be under tension and neuropraxia may appear. 28 Three fibular nerve lesions were detected, two of which presented valgus deformity. The treatment was conservative in two of them; neurolysis was performed on the third case in the second postoperative month and there was total recovery in all of them.…”

Section: Discussionmentioning

confidence: 99%

“…The other case of loosening, described previously, presented trans-operative femoral condyle fracture, and was successfully submitted to review. Among the factors that lead to aseptic loosening, special emphasis is placed on inadequate positioning of the tibial or femoral component in the sagittal plane, in an inexact lateral rotation that provokes lateralization of the extensor apparatus, angular deviations that favor the formation of polyethylene debris 26,28 : or asymmetries in the articular space in flexion, causing abnormal laxity and tensions in the compartment in which the space is more narrow and the polyethylene with thickness compatible with the slacker side. 29 In an abnormal situation such as the one described, if bone resection is minimal, there will be exacerbation of the situation, due to attempts to use implants of reduced thickness, which are subject to earlier wear and tear, whereas the minimum thickness compatible with a good durability is 8 mm.…”

Section: Discussionmentioning

confidence: 99%

Artroplastia total do joelho com o apoio tibial móvel: avaliação dos resultados a médio prazo

et al. 2010

View full text Add to dashboard Cite

OBJETIVO: Avaliações dos resultados a médio prazo da aplicação da prótese com apoio tibial móvel. MÉTODOS: Noventa e seis pacientes (107 joelhos) foram submetidos a artroplastia total do joelho realizada com um modelo de prótese com mobilidade rotatória no componente tibial. Os pacientes foram avaliados após um seguimento médio de 52,7 meses - desvio padrão 21,94 (mínimo de 24 meses e máximo de 120 meses), através do protocolo de avaliação "Knee Society Clinical Rating System" (KSCRS), com uma média de 78,22 pontos. RESULTADOS: Entre as complicações transoperatórias e pós operatórias imediatas ocorreram uma deiscência de sutura, com cura espontânea, duas fraturas de patela, uma fratura do côndilo medial do fêmur, três paresias do nervo fibular lateral e uma distrofia nervosa simpático reflexa. As complicações tardias foram uma fratura da patela, uma fratura distal do fêmur, quatro solturas assépticas e quatro infecções profundas, que necessitaram de revisão. CONCLUSÃO: Excluindo-se os casos que necessitaram de uma revisão, por soltura séptica ou asséptica, os autores concluem serem bons os resultados clínicos e funcionais obtidos com a prótese com o apoio tibial móvel num seguimento a médio prazo.

show abstract

“…On the other hand, after a retrospective review of 1476 primary TKA, Schinsky et al 11 identified 19 patients with a documented neurologic complication with an overall incidence of 1.3%. They encountered a larger percentage of neurologic injury in rheumatoid knees than was expected.…”

Section: Discussionmentioning

confidence: 99%

Bilateral total knee arthroplasty after spontaneous osseous ankylosis in rheumatoid arthritis

et al. 2005

View full text Add to dashboard Cite

Total knee arthroplasty (TKA) was carried out on both knee joints for spontaneous bony ankylosis due to rheumatoid arthritis (RA). Preoperative fixation angles were 40 degrees . First, the peroneal nerve was released prior to TKA. Quadriceps snip was performed to evert the patella laterally. Bilateral TKAs were carried out using a stabilized prosthesis. The results showed full extension to 70 degrees flexion at 3 years after the surgery. Absence of pain, maintenance of stability, and walking ability were achieved, without any significant complication. Total knee arthroplasty following takedown of a spontaneous ankylosed knee is an effective procedure under appropriate knee conditions.

show abstract

Nerve injury after primary total knee arthroplasty

Cited by 115 publications

References 14 publications

Total knee arthroplasty in the valgus knee

Total knee arthroplasty in the valgus knee

Artroplastia total do joelho com o apoio tibial móvel: avaliação dos resultados a médio prazo

Bilateral total knee arthroplasty after spontaneous osseous ankylosis in rheumatoid arthritis

Contact Info

Product

Resources

About