SURGICAL DECOMPRESSION FOR PERONEAL NERVE PALSY AFTER TOTAL KNEE ARTHROPLASTY

Five patients were treated by operative exploration and decompression of the peroneal nerve for peroneal nerve palsy complicating total knee arthroplasty (TKA). All patients bad failed to demonstrate improvemen t in the peroneal nerve function despite extended conservative care. T he procedure was performed five to 45 months after the index TKA. Pati ents were evaluated and graded preoperatively and postoperatively usin g the Modified Nerve Palsy Scale of Weber, Daube, and Coventry. All pa tients demonstrated improved nerve function. Four of five patients had full peroneal nerve recovery. All patients were able to discontinue t heir ankle-foot orthoses. This is a rare complication of TKA, and when conservative nonoperative measures do not lead to sufficient improvem ent in nerve function, consideration may be given to operative decompr ession of the peroneal nerve.