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J R Soc Med. 1994 November; 87(11): 701–703.
PMCID: PMC1294942

Intra-operative monitoring of the common peroneal nerve during total knee replacement.

Abstract

We present a method allowing intra-operative monitoring of the common peroneal nerve during total knee arthroplasty using a magnetic stimulator. Previous reports have shown no pre-operative method successful in selecting those patients prone to develop a post-operative palsy. The device, placed beneath the lumbar spine, stimulates the cauda equina; common peroneal nerve function is assessed via the response in extensor digitorum brevis. There is a loss of signal from the nerve with the use of a tourniquet 25 min following its application. The protocol therefore requires that a tourniquet is used at least only for fixation of the prosthetic components. The method is quick, safe, non-invasive and reproducible, and is of use both in at-risk patients and in research work.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Rose HA, Hood RW, Otis JC, Ranawat CS, Insall JN. Peroneal-nerve palsy following total knee arthroplasty. A review of The Hospital for Special Surgery experience. J Bone Joint Surg Am. 1982 Mar;64(3):347–351. [PubMed]
  • Knutson K, Leden I, Sturfelt G, Rosén I, Lidgren L. Nerve palsy after knee arthroplasty in patients with rheumatoid arthritis. Scand J Rheumatol. 1983;12(3):201–205. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press