Postoperative numbness of the knee following total knee arthroplasty

Black, Rachelle; Green, C; Sochart, David H.

doi:10.1308/rcsann.2013.95.8.565

Cited by 14 publications

(9 citation statements)

References 12 publications

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“…The patients had to undergo KR at least one year before. The fact that some of the numbness around the knee improved within one year and that there was no improvement after one year in previous studies supports our findings [ 4 , 21 ].…”

Section: Discussionsupporting

confidence: 92%

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Is the Numbness after Knee Replacement a More Critical Complication Than Thought? A Detailed Analysis of Neuropathic Pain and Functional Outcomes

Gürler

Büyükceran

2022

Medicina

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Background and Objectives: Numbness, one of the complications after knee replacement (KR), has been studied far less than other complications, and there are few studies on this topic. Without comprehensive research on numbness, there is a need to design a study that includes all relevant parameters. This study investigated the relationship between numbness and pain and neuropathic pain and its impact on functional and emotional life and the functioning of the knee. Materials and Methods: The 105 knees with KRs were divided anteriorly into six regions. Numbness was determined with a pinprick test. Douleur Neuropathique 4 (DN4) and a painDETECT questionnaire (PD-Q) were tested for neuropathic pain. Patients’ physical, emotional, and social status and functional knee abilities were assessed with the Short Form (SF-36) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) test. The relationships between numbness and gender, age, bilaterality, postoperative follow-up time, and incision measures were examined. The binomial logistic regression model was applied to investigate the effects of age, gender, bilaterality, incision length, and postoperative follow-up time on numbness. Results: A total of 88.6% of the patients were female, half had bilateral KRs, and the mean age was 68.3 years. Numbness occurred more frequently in the L3 and L2 areas than in other regions. There was no association with gender, bilaterality, and age, but there was a weak association with postoperative follow-up time. There was a positive correlation between numbness and neuropathic pain. It has been found that there is a significant relationship between numbness and physical function, and it has a negative effect. Emotional health was not significantly associated with numbness. The effect of numbness on social functioning was statistically significant. Knee functioning was measured with the WOMAC, and significant differences were found in the numbness group. Conclusions: According to the results, numbness is considered to be a complication that affects social and physical life and has a negative impact on functional outcomes of the knee. The results show that it should be considered a statistically significant complication. Numbness and its indirect effects should be considered in patients whose follow-up parameters are normal over one year but whose symptoms do not resolve.

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Section: Discussionsupporting

confidence: 92%

“…Numbness is not considered as significant a complication as it should be. Different data on incidence have been published, ranging from 37–55% [ 4 ] to 71–100% [ 5 ]. Even in terms of incidence, the wide range of results and uncertain, conflicting data indicate that the topic deserves a new study.…”

Section: Introductionmentioning

confidence: 99%

Is the Numbness after Knee Replacement a More Critical Complication Than Thought? A Detailed Analysis of Neuropathic Pain and Functional Outcomes

Gürler

Büyükceran

2022

Medicina

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“…5,23 Many studies have reported hyperesthesia and hypoesthesia around the incision after TKA. [24][25][26] Retrospective studies with different followup periods showed that 60% of TKA patients using the midline skin incision technique had hyperesthesia. 26 Black et al 25 found that 27% of patients had a symptom of numbness in the incision area after TKA.…”

Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty Postsurgical Chronic Pain, Neuropathic Pain, and the Prevalence of Neuropathic Symptoms: A Prospective Observational Study in Turkey

Şahin¹,

Beyaz²,

Karakuş

et al. 2021

JPR

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Purpose: Chronic post-surgical pain (CPSP) is a detrimental condition that persists at least two months after surgical procedures and seriously affects patients' quality of life. Although its incidence varies according to operation types and definitions, its prevalence is between 3% and 85%. The purpose of this study is to evaluate the prevalence of CPSP and neuropathic pain in patients undergoing TKA for osteoarthritis. Patients and Methods: In this study, patients who had undergone total knee arthroplasty (TKA) were examined prospectively and observationally. 42 patients were included in the study. Numeric rate scale (NRS) for developing chronic pain, Douleur Neuropathique 4 (DN-4) questionnaire to evaluate neuropathic pain and symptoms, and von Frey filaments to evaluate mechanical hyperesthesia and alladony. Results: NRS scores were 1 or higher for all patients. Twenty-seven patients constituted the mild pain group (NRS: 1-4), and 15 patients constituted the moderate pain group (NRS: 4-7). The number of patients defined as having "neuropathic pain," according to DN-4 scores, was 17 (40.4%; DN-4 ≥ 4). The moderate pain group reported greater severity of neuropathic symptoms on average than the mild pain group (p = 0.039). When patients knees affected by TKA were divided into suprapatellar, patellar, and infrapatellar regions and evaluated with von Frey filaments, a significant difference was found between the three regions (p < 0.05). Conclusion:In this study, we showed-unlike other studies-that the rate of neuropathic pain was higher among CPSP patients, and all patients had neuropathic symptoms. In evaluating patients knees with von Frey filaments, we showed that the neuropathic component of patients' pain occurred mostly in the knee's infrapatellar region. Although the incidence of CPSP and neuropathic pain in these patients was higher than expected, we think CPSP, its diagnosis, and its treatment present an important issue that requires further examination.

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“…Second, a retrospective study design was used, and the mean follow-up duration of 28.0 months was relatively short. It has been reported that complaints of numbness were more common in the first 3 years after TKA than from 6 years onward after TKA [ 40 ], suggesting that numbness would decrease as the duration increases. Therefore, our mean follow-up may have occurred when numbness was frequent.…”

Section: Discussionmentioning

confidence: 99%

Correlation of patient-reported numbness around surgical scars with patient-reported outcome measures and joint awareness after knee replacement: a cohort study

Itoh

Itou

Kuwashima

et al. 2022

BMC Musculoskelet Disord

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Background Knee replacement is a very effective and indispensable treatment option for end-stage knee arthritis, and the number of cases has been increasing worldwide. A replaced knee joint without patient joint awareness is thought to be the ultimate goal of artificial knees. Joint awareness reportedly correlates with patient satisfaction. Although numbness around a replaced knee is a minor but common problem, its effect on postoperative outcome is controversial. Joint awareness also is sensitive to subtle abnormalities of the joint, so it must be negatively affected by numbness. Although numbness is minor, it cannot be ignored to further improve knee replacement outcomes. This study investigated the relationship between patient-reported numbness and other patient-reported outcome measures (PROMs), including joint awareness, and kneeling. We developed a numbness score based on a 5-point Likert scale on frequency of numbness, with an intraclass correlation coefficient of 0.76 and higher scores indicating less numbness. Methods The numbness score, New Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS), Forgotten Joint Score-12 (FJS-12), and other clinical and radiological data from 311 patients (394 primary knee replacements) were analyzed. Kneeling ability was evaluated by using kneeling-specific items in the KSS (KSS-Kneeling). Results No numbness was found in 170 knees (43.1%), and some degree of numbness was found in the remaining 224 knees (56.9%). The numbness score showed weak-to-moderate correlations with KSS-Symptoms (r = 0.44), KSS-Satisfaction (r = 0.41), KSS-Activities (r = 0.29), and all KOOS subscales (r = 0.23–0.44), and FJS-12 (r = 0.42). Multiple regression analyses suggested that midline incision positively affected the numbness score over the anteromedial incision (p = 0.04) and that a better numbness score (p = 0.001), male sex (p < 0.0001), and better postoperative knee flexion angle (0.04) positively affected kneeling. Conclusions The numbness score positively correlated with PROMs and positively affected kneeling. Knee replacements performed via an anteromedial incision may be at higher risk for numbness.

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Postoperative numbness of the knee following total knee arthroplasty

Cited by 14 publications

References 12 publications

Is the Numbness after Knee Replacement a More Critical Complication Than Thought? A Detailed Analysis of Neuropathic Pain and Functional Outcomes

Is the Numbness after Knee Replacement a More Critical Complication Than Thought? A Detailed Analysis of Neuropathic Pain and Functional Outcomes

Total Knee Arthroplasty Postsurgical Chronic Pain, Neuropathic Pain, and the Prevalence of Neuropathic Symptoms: A Prospective Observational Study in Turkey

Correlation of patient-reported numbness around surgical scars with patient-reported outcome measures and joint awareness after knee replacement: a cohort study

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