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TY - JOUR

T1 - Common peroneal nerve palsy after TKA in valgus deformities; a systematic review

AU - Puijk, Raymond

AU - Rassir, Rachid

AU - Kok, Laura M.

AU - Sierevelt, Inger N.

AU - Nolte, Peter A.

N1 - Funding Information: We would like to thank Marjolein Schager of the Spaarne Gasthuis for assistance in drafting the manuscript and Willy Salemink of the Spaarne Gasthuis Library for the librarian-assisted search. Publisher Copyright: © 2022, The Author(s).

PY - 2022/12/1

Y1 - 2022/12/1

N2 - Purpose: The aim of this systematic review is to investigate the prevalence of Common Peroneal Nerve Palsy after total knee arthroplasty in valgus deformities. Furthermore, the effectiveness of a peroneal nerve release prior to arthroplasty to prevent the palsy will be investigated. Methods: PubMed and Google Scholar were searched. Search terms regarding valgus deformity and total knee arthroplasty were used. Data analysis and extraction were performed using the web application ‘Rayyan QCRI’ according to PRISMA guidelines and screened according to the inclusion and exclusion criteria. Results: Twenty-seven studies were included, representing 1397 valgus knees. Knee balancing was performed in 19 studies with lateral soft tissue releases (1164 knees) and 8 studies (233 knees) with an additional osteotomy. Two studies (41 knees) in the lateral soft tissue release group conducted a peroneal nerve release simultaneous to arthroplasty. Common peroneal nerve palsies occurred in 26 cases (1.9%). Overall, no significant difference in palsy ratio between studies was found by using a peroneal nerve release (p = 0.90), between lateral soft tissue releases and osteotomies (p = 0.11) or between releases of specific ligaments. Conclusion: Common peroneal nerve palsies occur in 1.9% of the cases after total knee arthroplasty in valgus deformities. No difference in the number of palsies was seen when using a peroneal nerve release or using different balancing techniques. However, literature about peroneal nerve releases was very limited, therefore, the effectiveness of a peroneal nerve release remains unclear. Level of evidence: LEVEL III: Systematic review.

AB - Purpose: The aim of this systematic review is to investigate the prevalence of Common Peroneal Nerve Palsy after total knee arthroplasty in valgus deformities. Furthermore, the effectiveness of a peroneal nerve release prior to arthroplasty to prevent the palsy will be investigated. Methods: PubMed and Google Scholar were searched. Search terms regarding valgus deformity and total knee arthroplasty were used. Data analysis and extraction were performed using the web application ‘Rayyan QCRI’ according to PRISMA guidelines and screened according to the inclusion and exclusion criteria. Results: Twenty-seven studies were included, representing 1397 valgus knees. Knee balancing was performed in 19 studies with lateral soft tissue releases (1164 knees) and 8 studies (233 knees) with an additional osteotomy. Two studies (41 knees) in the lateral soft tissue release group conducted a peroneal nerve release simultaneous to arthroplasty. Common peroneal nerve palsies occurred in 26 cases (1.9%). Overall, no significant difference in palsy ratio between studies was found by using a peroneal nerve release (p = 0.90), between lateral soft tissue releases and osteotomies (p = 0.11) or between releases of specific ligaments. Conclusion: Common peroneal nerve palsies occur in 1.9% of the cases after total knee arthroplasty in valgus deformities. No difference in the number of palsies was seen when using a peroneal nerve release or using different balancing techniques. However, literature about peroneal nerve releases was very limited, therefore, the effectiveness of a peroneal nerve release remains unclear. Level of evidence: LEVEL III: Systematic review.

KW - Common peroneal nerve palsy

KW - Peroneal nerve release

KW - Soft tissue release

KW - Total knee arthroplasty

KW - Valgus deformity

UR - http://www.scopus.com/inward/record.url?scp=85123384816&partnerID=8YFLogxK

U2 - 10.1186/s40634-021-00443-x

DO - 10.1186/s40634-021-00443-x

M3 - Article

C2 - 35059901

VL - 9

JO - Journal of experimental orthopaedics

JF - Journal of experimental orthopaedics

SN - 2197-1153

IS - 1

M1 - 12

ER -