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Neuropathy Dermatitis: An Underdocumented Complication Following Total Knee Arthroplasty

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Abstract

Background

Midline surgical incision used in Total Knee Arthroplasty (TKA) is associated with iatrogenic injury to the infrapatellar branch of the saphenous nerve, which leads to neuropathic dermatitis around the healed surgical scar. There are very few studies with a limited number of cases that have reported this complication. We evaluated the incidence of neuropathic dermatitis and its implication for the functional outcome in TKA patients.

Methodology

Patients who underwent primary TKA between 1 January 2010 and 31 August 2019 and presented in follow-up with sensory disturbances and skin lesions adjacent to the surgical incision were evaluated in this study.

Results

A total of 3318 patients with 4282 TKAs were included, of which 188 patients presented with the clinical picture of neuropathic dermatitis. There were 136 females and 52 males with a mean age of 67.13 years (range 37–92 years). The mean duration from surgery to the appearance of skin lesions was 4.4 months (range 2–6 months), and they resolved at a mean duration of 7.67 (range 6–12) weeks. In our study, we found an incidence of 5.52%. All these patients had a stable and well-functioning knee at the time of presentation of the lesion with a mean Knee Society Score (KSS) of 92 (range 84–96).

Conclusion

In our study, we found the incidence of neuropathic dermatitis to be 5.52%, without any long-term implication on the functional outcome of operated knees. For a self-limiting complication of midline knee incision of TKA, it either resolves on its own or requires a short duration of topical steroid application.

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Authors and Affiliations

  1. Sparsh Hospitals, Bangalore, India

    Ravikumar Mukartihal, Phuljit Patowary, Udit Kumar Biswal & Pradeep A. Ramesh

  2. Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, 342005, India

    Rajesh Kumar Rajnish

  3. Sparsh Group of Hospitals, Bangalore, India

    Sharan Shivaraj Patil

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  1. Ravikumar Mukartihal
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  4. Udit Kumar Biswal
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  5. Pradeep A. Ramesh
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Contributions

All the above-mentioned authors have made substantial contributions to all of the following: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final approval of the version to be submitted.

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Correspondence to Rajesh Kumar Rajnish.

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Mukartihal, R., Rajnish, R.K., Patowary, P. et al. Neuropathy Dermatitis: An Underdocumented Complication Following Total Knee Arthroplasty. JOIO 57, 445–452 (2023). https://doi.org/10.1007/s43465-023-00835-4

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  • DOI: https://doi.org/10.1007/s43465-023-00835-4

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