Citation

Shetty T, Nguyen JT, Sasaki M, Wu A, Bogner E, Burge A, Cogsil T, Dalal A, Halvorsen K, Cummings K, Su EP, Lyman S. Muscle Nerve 2018; 57(6): 946-950.

Affiliation

Healthcare Research Institute, Hospital for Special Surgery, 535 E70th Street, New York, NY, 10021.

Copyright

(Copyright © 2018, John Wiley and Sons)

DOI

10.1002/mus.26045

PMID

29266269

Abstract

INTRODUCTION: This study identifies potential risk factors for post-total knee arthroplasty (TKA) nerve injury, a catastrophic complication with a reported incidence of 0.3% to 1.3%.

METHODS: Patients who developed post-TKA nerve injury from 1998 to 2013 were identified, and each was matched with 2 controls. A multivariable logistic regression model was built to calculate odds ratios (OR).

RESULTS: 65 nerve injury cases were identified in 39,990 TKAs (0.16%). Females (OR 3.28, p=0.003) and patients with history of lumbar pathology (OR 6.12, p=0.026) were associated with increased risk of nerve injury. Tourniquet pressure <300 mmHg and longer duration of anesthesia may also be risk factors.

DISCUSSION: Surgical planning for females and patients with lumbar pathology should be modified to mitigate their higher risk of neurologic complications after TKA. Our finding that lower tourniquet pressure was associated with higher risk of nerve injury was unexpected and requires further investigation. This article is protected by copyright. All rights reserved.

© 2017 Wiley Periodicals, Inc.

Language: en

Keywords

Acute nerve injury; Anesthesia; Nerve palsy; Risk factors; Sex; Spine Disease; Surgical complication; Total knee arthroplasty; Tourniquet Pressure