Peroneal nerve palsy is a potentially devastating
complication of total knee arthroplasty (TKA).
Fortunately, review of the literature reveals that
this is not a common problem. Retrospective
studies examining a large number of consecutive
TKAs (N 1000) performed at various institutes show
an incidence ranging from 0.3% to 1.3% (Table 1).
In smaller studies, the incidence can vary more
widely. The reported incidences have been as low
as 0% and as high as 10%. This variability may be
caused by the specific patient population enrolled
in the studies [5-7] or the specific prostheses used
in the studies [8,9]. In addition, the number of
surgeons involved and their experience may have a
greater impact on the incidence in studies with
small sample sizes.
The reported clinical incidences may not represent
the true incidence of peroneal nerve palsy. The
actual incidence of nerve compromise may be
underestimated because of the presence of subclinical
palsy, which may only be diagnosed by means
of electrodiagnostic tests such as electromyography
(EMG) or nerve conduction studies. Moreover, the
different methods of gathering data (chart review
vs follow-up vs complication reports) may also
result in discrepancies between reported and true
incidences. We found no prospec