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No common peroneal nerve palsies found after a peroneal nerve release prior to TKA in fixed valgus deformities (a retrospective cohort study)

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The main purpose of this study was to analyse the incidence of Common Peroneal Nerve Palsy (CPNP) after Total Knee Arthroplasty (TKA) for all alignments. Secondarily, the efficiency and safety of a Peroneal Nerve Release (PNR) prior to TKA in preoperative severe fixed valgus deformities were evaluated to prevent a CPNP.

Methods

Overall, 7612 TKAs were performed in the institution from 2009 to 2021. 1913 TKAs were performed by three surgeons, who consistently performed a PNR in case of a fixed valgus deformity of (1) more than 15°, or (2) more than 10° but in combination with a flexion contracture of more than 15°. Patients with fixed valgus deformities of more than 10° were identified (81 knees) and a comparison was made between the patients who received a PNR (26 knees) and those who did not receive a PNR (55 knees). Data for the analysis were collected from patient medical files and were compared with the Chi2-test or Fisher Exact test.

Results

A CPNP incidence of 0.2% (16/7612) was found after TKA for all alignments together. No CPNP cases (0%) were developed in the PNR-group, compared to five (9%) in the non-PNR group (p = NS). A larger preoperative valgus angle (17° vs 13°, p < 0.001) and flexion contracture (10° vs 3°, p < 0.001) was present in the PNR group compared with the non-PNR group. No PNR-related complications were reported.

Conclusion

The CPNP incidence in this study is consistent with the previous literature. Furthermore, although not significant, the group that received a PNR procedure developed fewer CPNPs compared to the group without PNR.

Level of evidence

Retrospective cohort study, III.

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Abbreviations

TKA:

Total knee arthroplasty

OA:

Osteoarthritis

CPN:

Common peroneal nerve

CPNP:

Common peroneal nerve palsy

PNR:

Peroneal nerve release

aFTA:

Anatomic femorotibial angle

AP:

Anteroposterior

ICC:

Intraclass correlation coefficient

EMR:

Electronic medical records

LIA:

Local infiltrate analgesia

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Acknowledgements

We thank Marjolein Schager RN, MDiv, for her help with English-language proofreading.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Spaarne Gasthuis, Spaarnepoort 1, 2134 TM, Hoofddorp, The Netherlands

    Raymond Puijk, Rachid Rassir, Laura M. Kok, Inger N. Sierevelt, Diederik A. Vergroesen, Bernard G. Schutte & Peter A. Nolte

  2. Specialized Center of Orthopedic Research and Education (SCORE), Xpert Orthopedie, Amsterdam, The Netherlands

    Inger N. Sierevelt

Authors
  1. Raymond Puijk
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  2. Rachid Rassir
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  3. Laura M. Kok
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  4. Inger N. Sierevelt
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  5. Diederik A. Vergroesen
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  6. Bernard G. Schutte
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  7. Peter A. Nolte
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Contributions

All authors contributed to the conception and design of the study; RP and IS contributed to the acquisition and analysis of data; RP wrote the manuscript; All authors helped draft the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Raymond Puijk.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Institutional Review Board (ACLU# 2021.0026).

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No informed consent was needed for this study.

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Puijk, R., Rassir, R., Kok, L.M. et al. No common peroneal nerve palsies found after a peroneal nerve release prior to TKA in fixed valgus deformities (a retrospective cohort study). Knee Surg Sports Traumatol Arthrosc 30, 4010–4014 (2022). https://doi.org/10.1007/s00167-022-06891-x

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  • DOI: https://doi.org/10.1007/s00167-022-06891-x

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