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. 2020 Aug 22;6(4):662-667.
doi: 10.1016/j.artd.2020.07.017. eCollection 2020 Dec.

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

Christopher N Carender  1 , Nicholas A Bedard  1 , Qiang An  1 , Timothy S Brown  1
Affiliations

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

Christopher N Carender et al. Arthroplast Today. .

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.

Keywords: Common peroneal nerve; Natural history; Palsy; Risk factor; Total knee arthroplasty.

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Figures

Figure 1
Figure 1
PRISMA flow diagram. The flow diagram of study selection per guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) group.
Figure 2
Figure 2
Rates of recovery of incomplete and complete common peroneal nerve palsy. One hundred twenty-nine CPNPs from 6 studies [1,2,5,7,13,15] were included in this analysis. Outcomes shown occurred at a mean follow-up of 3.6 y after surgery (range, 0-11 y). Data are reported in percentages of the total number of classifiable complete or incomplete palsies.
See this image and copyright information in PMC

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