Clinical spectrum of neuropathy after primary total knee arthroplasty: A series of 54 cases

Introduction: Neuropathy after total knee arthroplasty (TKA) can cause significant morbidity but is inconsistently reported. Methods: We reviewed the clinical, electrodiagnostic and perioperative features of all patients who underwent primary TKA at our institution and developed a new neuropathy within 8 weeks postoperatively. Results: Fifty-four cases were identified (incidence 0.37% [95% confidence interval, 0.28–0.49]) affecting the following nerve(s): peroneal (37), sciatic (11), ulnar (2), tibial (2), sural (1), and lumbosacral plexus (1). In all cases with follow-up data, motor recovery typically occurred within 1 year and was complete or near-complete. Conclusions: Post-TKA neuropathy is uncommon, typically does not require intervention and usually resolves within 1 year. Post-TKA neuropathy most often affects the nerves surgically at risk. Anesthesia type does not correlate with post-TKA neuropathy. An inflammatory etiology for post-TKA neuropathy is rare but should be considered in specific cases. Muscle Nerve 59:679–682, 2019.