Delayed peroneal nerve palsy after total knee arthroplasty—A rare complication of tibial osteolysis

Deshmukh, Ajit; Kuczynski, Bozena; Scuderi, Giles R.

doi:10.1016/j.knee.2013.10.015

Cited by 6 publications

(1 citation statement)

References 15 publications

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“…They believed that some patients with atypical common peroneal nerve impairments were unrecognized and not diagnosed. The risk factors reported for CPNP include: preoperative valgus deformity, preoperative flexion contracture 3,5 , rheumatoid arthritis 12 , prolonged tourniquet time 6 , constrictive dressing, compression from hematomas, postoperative epidural analgesia 10 , higher BMI 1 , previous spinal pathology 9,10 , compression from a pseudotumor 8 , and tibial osteolytic cyst compression 13 . As far as we know, this is the first report of CPNP caused by fabella compression of the common peroneal nerve.…”

Section: Discussionmentioning

confidence: 99%

Common Peroneal Nerve Palsy Due to Giant Fabella After Total Knee Arthroplasty

Shen

Bai

Sun

et al. 2021

Orthopaedic Surgery

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Background: Common peroneal nerve palsy (CPNP) is a rare but serious complication following primary total knee arthroplasty (TKA). The common peroneal nerve is one of the main molecules of the sciatic nerve. CPNP is a series of symptoms caused by common peroneal nerve injury due to paralysis and atrophy of the fibula and tibia muscles. The main clinical symptoms are: ankle joint unable to extend back, toe unable to extend back, foot droop, walking in a steppage gait, and foot dorsal skin sensation having decreased or disappeared. If treatment is not timely, severe cases may result in atrophy of the anterior tibia and lateral calf muscles. The risk factors for CPNP include mechanical stretching of the nerve, disruption of the blood supply to the nerve, and compression of the nerve. The CPNP should be treated in a timely manner and according to the cause. Its function should be restored as soon as possible to avoid serious adverse consequences. It has negative effects on patients' life and physical and mental health. To our knowledge, this is the first study to describe CPNP due to a giant fabella after TKA. Case presentation: The present study reported on a 70-year-old female patient. The patient underwent a primary TKA of the right knee for osteoarthritis. Relevant examinations were conducted and the operation went smoothly. Three hours postoperation, a right partial CPNP was observed, with progressive aggravation over time. On palpation, there was a 2 × 2-cm fixed hard mass in the posterolateral aspect of the right knee, with mild tenderness to deep palpation. Radiographs demonstrated that a giant fabella was located at the posterolateral condyle of the right femur. Fabellectomy and neurolysis of the common peroneal nerve were performed. The peroneal nerve palsy resolved gradually after the operation. At 8-month follow up after fabellectomy and neurolysis, the function of the common peroneal nerve had fully recovered. Conclusions: The presence of giant feballa pressing on the common peroneal nerve should be considered when common peroneal nerve palsy occurs after TKA. Surgical exploration and release compression should be performed in a timely manner.

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Section: Discussionmentioning

confidence: 99%

Common Peroneal Nerve Palsy Due to Giant Fabella After Total Knee Arthroplasty

Shen

Bai

Sun

et al. 2021

Orthopaedic Surgery

View full text Add to dashboard Cite

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Treatment approach to isolated common peroneal nerve palsy by mechanism of injury: Systematic review and meta-analysis of individual participants’ data

Klifto

Azoury

Gurno

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Langzeitkomplikationen durch Polyethylenabrieb bei Knietotalendoprothese: ein Fallbericht

Aurich

2017

Z Orthop Unfall

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This is the case of an 84-year-old patient 18 years after total knee replacement. Regular follow-up examinations did not take place beyond 10 years of implantation, so that subsequent wear of the polyethylene insert was not detected. The patient presented because of knee pain, swelling of the calf, and a drop foot. Examination showed a large ganglion with pressure on the peroneal nerve, and a loose knee replacement with severe inlay wear and extensive osteolysis around the tibial and femoral implants. This rare case demonstrates the importance of regular clinical and radiological follow-up examinations after total joint replacements, particularly in the long term.

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Delayed peroneal nerve palsy after total knee arthroplasty—A rare complication of tibial osteolysis

Cited by 6 publications

References 15 publications

Common Peroneal Nerve Palsy Due to Giant Fabella After Total Knee Arthroplasty

Common Peroneal Nerve Palsy Due to Giant Fabella After Total Knee Arthroplasty

Treatment approach to isolated common peroneal nerve palsy by mechanism of injury: Systematic review and meta-analysis of individual participants’ data

Langzeitkomplikationen durch Polyethylenabrieb bei Knietotalendoprothese: ein Fallbericht

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