[Neurologic complications in implantation of knee endoprostheses. A clinical and EMG-documented study].

In a retrospectively studied group of 253 knee joints treated by total replacement, six (2.4%) nerve lesions were clinically diagnosed. In the vast majority there was damage to the peroneal nerve, and in a single case also to the tibial nerve. After between one and three years only two patients still had permanently impaired function. In a second prospective study of 27 patients, examined by EMG before and after surgery, signs of bland, fresh neural damage was found in just under 30% following implantation of a knee joint prosthesis. In none of the cases had clinically manifest defunctionalization symptoms occurred. In the subsequent course, proof of far-reaching remission of the subclinical lesions was obtained, also by EMG. The causes of the perioperatively inflicted nerve lesions are discussed; the correction of axial defects (knee-bending contracture, genu valgum) in particular seems a likely cause of neural damage.