Common Peroneal Nerve Injury and Recovery after Total Knee Arthroplasty: A Systematic Review

Abstract

Background: Common peroneal nerve palsy (CPNP) after total knee arthroplasty (TKA) may impact extremity pain and function. Incidence and rates of recovery of CPNP after TKA vary in the current literature. The purpose of this systematic review was to evaluate the incidence of incomplete and complete CPNP after TKA and rates of incomplete and complete recovery of nerve function in the absence of further surgical treatment. Methods: PubMed, Embase, and Cochrane Central were searched for studies published in the years 1970-2019. Studies evaluating incidence and recovery rates of CPNP in the absence of further surgical treatment were screened according to inclusion and exclusion criteria. Outcomes of interest included incidence of complete and incomplete CPNP and rates of incomplete and complete nerve recovery. Results: Eleven studies were included for qualitative analysis. In total, there were 47,585 TKAs performed, with 203 postoperative CPNPs, for a cumulative incidence of 0.4%. One hundred twenty-nine CPNPs were classified as complete or incomplete palsies. At a mean follow-up of 3.6 years (range, 0-11 years), 24 (39%) complete CPNPs had complete recovery, 34 (56%) had incomplete recovery, and 3 were lost to follow-up. In contrast, 45 (66%) with incomplete CPNPs had complete recovery, 18 (27%) had incomplete recovery, and 5 patients were lost to follow-up. Conclusions: Incidence of CPNP after TKA was 0.4%. Recovery of nerve function after CPNP in the setting of TKA varies by the degree of initial nerve palsy. These data may be used to inform decisions on further interventions and for the purposes of perioperative patient counseling after TKA.

Common peroneal nerve palsy after TKA in valgus deformities; a systematic review

“…The obtained overall CPNP ratio of 1.9% in this study falls within the known range of TKA-V (0.3% - 9.5%) [ 3 , 9 – 17 ]. Other systematic review reported a range of 0.01% to 4.3%, like the one of Carender et al [ 2 ] and Rodríguez-Merchán et al [ 50 ]. Currently, controversy still exists related to valgus deformity being a predisposing factor of CPNP.…”

Demography of Total Joint Replacement Surgeries Performed in a Tertiary Care Hospital: A Cross-sectional Survey

“…Common peroneal nerve (CPN) palsy in post-TKR is relatively rare, estimating around 0.4% that too is more common in Rheumatoid and valgus knees. 19,20 We had also one lady with Rheumatoid and valgus knee where we performed simultaneous bilateral total knee arthroplasty in a single setting but she suffered from CPN palsy postoperatively in the left knee that recovered completely after 3 months of physiotherapy.…”

Peroneal nerve palsy (injury) in fibullar tunnel syndrome

“…К факторам риска относят травмы голени и колена, ортопедические операции на малоберцовой и большеберцовой костях и поведенческие причины, такие как длительное поддержание позы со скрещенными ногами, сидение на корточках, быстрое снижение массы тела [3]. Травматическое повреждение малоберцового нерва при остео томиях большеберцовой кости в сочетании с остео томией малоберцовой кости описано в 2-27 % случаев, при травмах голени частота таких повреждений может достигать 16-40 %, при эндопротезировании коленного сустава -около 0,4 % [4,5]. К факторам риска развития послеоперационной нейропатии относят использование эпидуральной анестезии, наличие сгибательных контрактур, более высокий индекс массы тела и сахарный диабет в анамнезе [6][7][8].…”