Peroneal nerve palsy after total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Neurology
• Rehabilitation Medicine

Background:

• Peroneal palsy is a known complication following total knee arthroplasty (TKA).
• The long-term prognosis and predictive factors for peroneal palsy after TKA remain poorly understood.
• Understanding recovery patterns is crucial for patient counseling and surgical decision-making.

Purpose of the Study:

• To define the prognosis of peroneal palsy after TKA.
• To identify factors associated with recovery from peroneal palsy post-TKA.
• To provide prognostic information for surgeons managing this complication.

Main Methods:

• Retrospective review of 8,998 total knee arthroplasties (TKAs) performed between 1972 and 1985.
• Analysis of 26 cases of postoperative peroneal palsy, categorizing them by completeness and deficit type (motor/sensory).
• Assessment of recovery status at an average of 5.1 years post-TKA, correlating with initial presentation and knee function scores.

Main Results:

• Twenty-six peroneal palsies occurred post-TKA. Of these, 18 were complete and 8 were incomplete.
• Motor and sensory deficits were present in 23 cases; 3 had only motor deficits.
• Complete recovery occurred in 13 cases, partial in 12. Incomplete palsies and higher knee scores predicted better recovery.

Conclusions:

• Complete recovery from peroneal palsy after TKA is more probable for initially incomplete palsies.
• Patients with initially partial palsies and those achieving complete recovery demonstrated significantly higher knee scores.
• This study offers valuable prognostic insights for managing peroneal palsy, a persistent TKA complication.