Iatrogenic Sciatic Nerve Injury after Total Knee Arthroplasty.
10.4055/jkoa.2018.53.2.180
- Author:
Jae Bum KWON
1
;
Tae Bum OH
;
Won Kee CHOI
Author Information
1. Department of Orthopaedic Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea. cwk1009@hanmail.net
- Publication Type:Case Report
- Keywords:
sciatic nerve palsy;
tourniquets;
total knee arthroplasty
- MeSH:
Aged;
Aneurysm;
Arthroplasty, Replacement, Knee*;
Atrial Fibrillation;
Carotid Artery, Internal;
Female;
Humans;
Ischemia;
Knee;
Sciatic Nerve*;
Sciatic Neuropathy;
Sensation;
Surgeons;
Tourniquets
- From:The Journal of the Korean Orthopaedic Association
2018;53(2):180-184
- CountryRepublic of Korea
- Language:Korean
-
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.
