|
Year |
2002 |
|---|---|
|
Question Number |
261 |
|
Category |
Hip and Knee Reconstruction |
Question
Figure 70 shows the radiograph of an 80 year-old woman who reports the recent development of incapacitating left knee pain that renders her unable to walk. She has been advised to undergo left total knee arthroplasty. The patient is at increased risk for which of the following surgical or postoperative complications
1) Tibial component loosening
2) Knee dislocation
3) Increased polyethylene wear
4) Peroneal nerve palsy
5) Infection
Figures
Answer (click for answer)
Preferred Response: 4
The patient presented has genu valgum and plans to undergo TKA. The referenced paper cites a 3% risk of peroneal nerve palsy in this patient population due to extensive lateral release, followed by tethering of the shortened nerve over a relatively longer lateral aspect of the leg. In their series all palsies were transient, however there are many reports of patients with permanent deficits. The authors posit that the injury is ischimic secondary to venous entrapment rather than direct stretch injury to the peri or epineureum.
Reference: Easley ME, et al: Primary constrained condylar knee arthroplasty for the arthritic valgus knee. Clin Orthop 2000; 380; 58-64.