J Korean Orthop Assoc.  2018 Apr;53(2):180-184. 10.4055/jkoa.2018.53.2.180.

Iatrogenic Sciatic Nerve Injury after Total Knee Arthroplasty

• Kwon JB
• Oh TB
• Choi WK

• KMID: 2410067
• DOI: http://doi.org/10.4055/jkoa.2018.53.2.180

Abstract

Sciatic nerve palsy after total knee arthroplasty, accompanied by motor power weakness and electromyographic evidence, is a rare occurrence. In a 78-year-old female, pneumatic tourniquet was used for 72 minutes, with a pressure of 300 mmHg. The time and pressure are generally accepted values. We noticed sciatic nerve palsy showing motor power weakness and electromyographic evidence. One year after the operation, she recovered full motor power, but complained about a tingling sensation below the knee. Given that the nerve injury after using tourniquet was due to neural ischemia, and since our patient had vascular circulation problems such as atrial fibrillation and clip insertion due to internal carotid artery aneurysm, our patient can be considered as a high-risk patient with weakness to neural ischemic damage, even with the use of conventional tourniquet. Therefore, surgeons should be cautious when using tourniquet in patients with vascular circulation problems.

Keyword

sciatic nerve palsy; tourniquets; total knee arthroplasty

MeSH Terms

Aged
Aneurysm
Arthroplasty, Replacement, Knee*
Atrial Fibrillation
Carotid Artery, Internal
Female
Humans
Ischemia
Knee
Sciatic Nerve*
Sciatic Neuropathy
Sensation
Surgeons
Tourniquets

Figure

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  Figure 1 Sciatic nerve (arrow) around distal thigh (A) and common peroneal nerve (2 arrows) around the fibular head had no abnormality in an ultrasonography (B).

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  Figure 2 The patient underwent total knee arthroplasty due to varus knee osteoarthritis. Preoperation (A) and postoperation (B).

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