Risk factors for acute nerve injury after total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Neurology

Background:

• Nerve injury is a rare but serious complication following total knee arthroplasty (TKA).
• Understanding risk factors is crucial for preventing post-operative nerve damage.

Purpose of the Study:

• To identify demographic and clinical risk factors associated with nerve injury after TKA.
• To inform surgical planning and patient counseling.

Main Methods:

• A case-control study design was employed, matching nerve injury cases with controls.
• Multivariable logistic regression analysis was used to determine odds ratios (ORs) for identified risk factors.

Main Results:

• The incidence of nerve injury was 0.16% (65 cases in 39,990 TKAs).
• Female patients (OR 3.28) and those with a history of lumbar pathology (OR 6.12) had a significantly higher risk of nerve injury.
• Lower tourniquet pressure (<300 mm Hg) and longer anesthesia duration were also suggested as potential risk factors.

Conclusions:

• Female sex and pre-existing lumbar conditions are key risk factors for post-TKA nerve injury.
• Surgical strategies should be adapted for high-risk patients to minimize neurologic complications.
• The association between lower tourniquet pressure and increased nerve injury risk warrants further investigation.