Acute Common Peroneal Nerve Decompression After Total Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Neurology
• Rehabilitation Medicine

Background:

• Common peroneal nerve palsy (CPNP) is a potential complication following total knee arthroplasty (TKA), occurring in 0.3%–4% of cases.
• CPNP can result in significant disability, including foot drop and equinovarus deformity, if not promptly addressed.
• Early postoperative symptoms include ankle dorsiflexion weakness and reduced dorsal foot sensation.

Purpose of the Study:

• To describe the surgical technique and report outcomes of acute peroneal decompression for CPNP post-TKA.
• To evaluate the efficacy of early surgical intervention within 90 days of TKA for this specific nerve palsy.

Main Methods:

• Retrospective case series of 5 patients undergoing acute peroneal decompression within 90 days of TKA.
• Detailed description of the surgical technique involving nerve dissection, release, and decompression.
• Assessment of motor and sensory function recovery, including ankle dorsiflexion strength and dorsal foot sensation.

Main Results:

• All 5 patients demonstrated a return of motor and sensory function at an average follow-up of 12 weeks.
• Average motor strength improved to 4.6 out of 5.
• No preoperative motor or sensory deficits were noted in the affected foot prior to the onset of CPNP.

Conclusions:

• Acute peroneal decompression is a safe and effective treatment for common peroneal nerve palsy occurring after total knee arthroplasty.
• The procedure leads to good functional results and a rapid recovery of nerve function.
• Early surgical intervention within 90 days is a prudent option for managing this complication.