Teena Shetty1, Joseph T Nguyen2, Mayu Sasaki3, Anita Wu4, Eric Bogner5, Alissa Burge5, Taylor Cogsil1, Aashka Dalal6, Kristin Halvorsen1, Kelianne Cummings7, Edwin P Su8, Stephen Lyman2. 1. Department of Neurology, Hospital for Special Surgery, 535 East 70th Street, New York, New York, 10021, USA. 2. Healthcare Research Institute, Hospital for Special Surgery, New York, New York, USA. 3. Quality Research Center, Hospital for Special Surgery, New York, New York, USA. 4. Carolina Neurological Clinic, Charlotte, North Carolina, USA. 5. Department of Radiology, Hospital for Special Surgery, New York, New York, USA. 6. New York Medical College, Valhalla, New York, USA. 7. SUNY Downstate Medical Center, Brooklyn, New York, USA. 8. Adult Reconstruction, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.
Abstract
INTRODUCTION: In this we study identified potential risk factors for post-total knee arthroplasty (TKA) nerve injury, a catastrophic complication with a reported incidence of 0.3%-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 (ORs). RESULTS: Sixty-five 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 mm Hg 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. Muscle Nerve 57: 946-950, 2018.
INTRODUCTION: In this we study identified potential risk factors for post-total knee arthroplasty (TKA) nerve injury, a catastrophic complication with a reported incidence of 0.3%-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 (ORs). RESULTS: Sixty-five 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 mm Hg 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. Muscle Nerve 57: 946-950, 2018.
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Authors: Scott J A Speelziek; Nathan P Staff; Rebecca L Johnson; Rafael J Sierra; Ruple S Laughlin Journal: Muscle Nerve Date: 2019-04-04 Impact factor: 3.217