The Effect of Sensory Deficit After Total Knee Arthroplasty on Patient Satisfaction and Kneeling Ability

Abstract

Background Skin numbness after total knee arthroplasty is a common complication. The incidence in the literature is variable from 27% to 100%. However, there is conflicting evidence about the consequences of this complication. The purpose of this study was to evaluate if postoperative numbness influenced patient satisfaction or kneeling ability. Methods We recruited patients who underwent a total knee arthroplasty for osteoarthritis one to 5 years before the study. Sensation was measured using a Semmes-Weinstein, 10-gram monofilament. Measurements were taken in several zones around the incision, and overall sensory status was classified as full numbness, partial numbness, and no numbness. Patients completed a questionnaire evaluating their subjective numbness, overall satisfaction, and kneeling ability. We evaluated the effect of numbness on satisfaction and function. Results A total of 96 patients were enrolled. Thirty-four patients were classified as no sensory deficit, 29 as partial deficit, and 33 as full deficit. There were no differences in demographics. Out of all the patients that were found to have a sensory deficit, 54.8% of them did not report any subjective numbness. Average patient-reported satisfaction scores were 8.76/10, 8.97/10, and 8.48/10 for no numbness, partial numbness, and full numbness, respectively. Eleven out of 96 patients noted an inability to kneel. There was no statistical difference for satisfaction scores or kneeling ability between the groups. Conclusion Sensory deficit after total knee arthroplasty is a frequently reported complication. However, the majority of the patients do not report subjective sensory deficits. Postoperative numbness does not appear to affect patient satisfaction or kneeling ability.

Skin sensory alteration and kneeling ability following cruciate retaining total knee arthroplasty are not affected by the incision position: A randomised controlled trial of simultaneous bilateral surgery

“…These findings contrast with previous evidence suggesting that an anterolateral skin incision provided a smaller area of cutaneous dysesthesia and higher rates of kneeling ability [8, 10, 14] [11]. However, another study concluded that after three years of mean followup, residual numbness following TKA surgery is not a predisposing factor for low kneeling ability or subjective dissatisfaction [15].…”

No Effect of Oral Mecobalamin on Skin Numbness at 3 Months After Total Knee Arthroplasty

“…With their eyes closed, patients were asked to indicate the area that they felt to be numb on the translucent paper. This patient-reported AON was recorded as a value in cm 2 . The change in the AON was calculated by subtracting the AON at 3 months postoperatively from the AON at 2 weeks postoperatively.…”

“…Tanavalee et al reported the AON at 2 weeks after TKA to be as large as 51.7 cm 2 , which gradually reduced to 2.1 cm 2 by 1 year postoperatively 7 . Additional studies 5,6 have reported the maximum AON to be approximately 191 cm 2 to 219 cm 2 .…”

“…Although primary total knee arthroplasty (TKA) usually has a successful outcome, 11% to 19% of patients are still dissatisfied after surgery 1 , 2 . There are many reasons for patient dissatisfaction following primary TKA, with persistent skin numbness being one of the most frequently reported 2 .…”

“…Although primary total knee arthroplasty (TKA) usually has a successful outcome, 11% to 19% of patients are still dissatisfied after surgery 1 , 2 . There are many reasons for patient dissatisfaction following primary TKA, with persistent skin numbness being one of the most frequently reported 2 . An area of skin numbness (AON) around the surgical site is a common but unavoidable complication following primary TKA 3 , 4 because, once the skin incision around the knee is made, an infrapatellar branch of the saphenous nerve (IPBSN) is completely dissected (i.e., neurotmesis).…”