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Nerve injury after primary total knee arthroplasty
M F Schinsky1, W Macaulay, M L Parks
1Department of Orthopaedic Surgery, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
The Journal of Arthroplasty
|December 12, 2001
Summary
Peripheral nerve palsy after total knee arthroplasty (TKA) occurs in 1.3% of cases. Rheumatoid knees were more susceptible, but common risk factors were not confirmed in this study.
Area of Science:
- Orthopedic Surgery
- Neurology
Background:
- Peripheral nerve palsy is a potential complication following total knee arthroplasty (TKA).
- The incidence and predisposing factors for TKA-related nerve palsy remain controversial in existing literature.
Purpose of the Study:
- To determine the incidence of peripheral nerve palsy after primary total knee arthroplasty (TKA).
- To identify potential predisposing factors associated with neurologic complications post-TKA.
Main Methods:
- Retrospective review of 1,476 primary TKAs performed between 1970 and 1998.
- Analysis of 19 patients who developed documented neurologic complications.
Main Results:
- The overall incidence of peripheral nerve palsy after TKA was 1.3%.
- Valgus deformity, flexion contracture, epidural anesthesia, prolonged tourniquet use, and preexisting neuropathy were not statistically significant risk factors.
- Rheumatoid knees showed a higher incidence of neurologic injury than expected.
Conclusions:
- Peripheral nerve palsy following TKA is relatively uncommon, with an incidence of 1.3%.
- Contrary to prior beliefs, several commonly cited risk factors were not supported by this study's data.
- Rheumatoid arthritis may increase the risk of nerve injury after TKA.
- Conservative treatment led to favorable recovery outcomes for all affected patients.