Is Potential Malnutrition Associated with Increased Morbidity in Total Hip and Knee Joint Arthroplasty? A Prospective Cohort Study

Journal of Clinical Orthopaedics | Vol 9 | Issue 1 |  January-June 2024 | page: 04-09 | William James Caughey, Faseeh Zaidi, Christoper Jarred Shepherd, Claudia Rivera-Rodriguez, Rocco P Pitto


Author: William James Caughey [1,2], Faseeh Zaidi [1,2], Christoper Jarred Shepherd [1], Claudia Rivera-Rodriguez [3], Rocco Paolo Pitto [1,2]

[1] Department of Orthopaedic Surgery, Middlemore Hospital, Auckland, New Zealand,
[2] Department of Surgery, University of Auckland, Auckland, New Zealand,
[3] Department of Statistics, University of Auckland, Auckland, New Zealand.

Address of Correspondence
William James Caughey,
Department of Orthopaedic Surgery, Middlemore Hospital, Auckland, New Zealand.


Introduction: Malnutrition is considered a risk factor for post-operative complications in total hip and knee arthroplasty, though prospective studies to investigate this assumption are lacking. The aims of this study were to prospectively analyze the 90-day post-operative complications, post-operative length of stay (LOS), and readmission rates of patients undergoing primary total hip and total knee arthroplasty using albumin, total lymphocyte count (TLC), and transferrin as serum markers of potential malnutrition.
Materials and Methods: Six hundred and three primary hip and 823 primary knee arthroplasties over a 3-year period from a single center were prospectively analyzed. Body mass index, demographic, and comorbidity data were recorded. Complications were categorized as surgical site infection (SSI), venous thromboembolism (VTE) (deep vein thrombosis and pulmonary embolus), implant-related (such as dislocation), and non-implant-related (such as pneumonia). Outcomes were compared between groups, with malnutrition, defined as serum albumin <3.5 g/dL.
Results: Potential malnutrition was present in 9.3% of the study population. This group experienced a longer average LOS at 6.5 days compared to the normal albumin group at 5.0 days (P = 0.003). SSI rate was higher in the malnourished group (12.5 vs. 7.8%, P = 0.02). There was no difference between the two groups in implant-related complications (0.8 vs. 1.0%, P = 0.95) medical complications (7.8 vs. 13.3%, P = 0.17), rate of VTE (2.3 vs. 2.7%) or 90-day readmission rate (14.1 vs. 17.0%, P = 0.56). TLC and transferrin were not predictive of any of the primary outcomes measured (P > 0.05). Pacific Island (P < 0.001), Indian (P = 0.02), and Asian (P = 0.02) patients had lower albumin than NZ European.
Conclusion: This study demonstrates an association between low albumin levels and increased post-operative LOS and SSI in total joint arthroplasty, providing support for the consideration of pre-operative nutritional screening.
Keywords: Knee arthroplasty, hip arthroplasty, malnutrition, post-operative complications, hypoalbuminemia.


1. Albright F, Reifenstein EC Jr. The Parathyroid Glands and metabolic bone disease. Whitefish, MT: Literary Licensing, LLC; 1948.
2. Barrett-Connor E, Holbrook TL. Sex differences in osteoporosis in older adults with non-insulin-dependent diabetes mellitus. JAMA 1992;268:3333-7.
3. Gregorio F, Cristallini S, Santeusanio F, Filipponi P, Fumelli P. Osteopenia associated with non-insulin-dependent diabetes mellitus: What are the causes? Diabetes Res Clin Pract 1994;23:43-54.
4. Asokan AG, Jaganathan J, Philip R, Soman RR, Sebastian ST, Pullishery F. Evaluation of bone mineral density among type 2 diabetes mellitus patients in South Karnataka. J Nat Sci Biol Med 2017;8:94-8.
5. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 2007;92:2017-29.
6. Rucker D, Tonelli M, Coles MG, Yoo S, Young K, McMahon AW. Vitamin D insufficiency and treatment with oral vitamin D3 in northern-dwelling patients with chronic kidney disease. J Nephrol 2009;22:75-82.
7. Nicodemus KK, Folsom AR, Iowa Women’s Health Study. Type 1 and type 2 diabetes and incident hip fractures in postmenopausal women. Diabetes Care 2001;24:1192-7.
8. Strotmeyer ES, Cauley JA, Orchard TJ, Steenkiste AR, Dorman JS. Middle-aged premenopausal women with type 1 diabetes have lower bone mineral density and calcaneal quantitative ultrasound than nondiabetic women. Diabetes Care 2006;29:306-11.
9. Kayath MJ, Tavares EF, Dib SA, Vieria JG. Prospective bone mineral density evaluation in patients with insulin-dependent diabetes mellitus. J Diabetes Complications 1998;12:133-9.
10. Wakasugi M, Wakao R, Tawata M, Gan N, Koizumi K, Onaya T. Bone mineral density measured by dual energy x-ray absorptiometry in patients with non-insulin-dependent diabetes mellitus. Bone 1993;14:29-33.
11. Yamagishi S, Nakamura K, Inoue H. Possible participation of advanced glycation end products in the pathogenesis of osteoporosis in diabetic patients. Med Hypotheses 2005;65:1013-5
12. Vestergaard P, Rejnmark L, Mosekilde L. Relative fracture risk in patients with diabetes mellitus, and the impact of insulin and oral antidiabetic medication on relative fracture risk. Diabetologia 2005;48:1292-9.
13. Paul RG, Bailey AJ. Glycation of collagen: The basis of its central role in the late complications of ageing and diabetes. Int J Biochem Cell Biol 1996;28:1297-310.
14. Takeuchi M, Yamagishi S. TAGE (toxic AGEs) hypothesis in various chronic diseases. Med Hypotheses 2004;63:449-52.
15. Takeuchi M, Yamagishi S. Alternative routes for the formation of glyceraldehyde-derived AGEs (TAGE) in vivo. Med Hypotheses 2004;63:453-5.
16. Yamagishi S, Inagaki Y, Amano S, Okamoto T, Takeuchi M, Makita Z. Pigment epithelium-derived factor protects cultured retinal pericytes from advanced glycation end product-induced injury through its antioxidative properties. Biochem Biophys Res Commun 2002;296:877-82.
17. Miyata T, Notoya K, Yoshida K, Horie K, Maeda K, Kurokawa K, et al. Advanced glycation end products enhance osteoclast-induced bone resorption in cultured mouse unfractionated bone cells and in rats implanted subcutaneously with devitalized bone particles. J Am Soc Nephrol 1997;8:260-70.
18. Hein G, Wiegand R, Lehmann G, Stein G, Franke S. Advanced glycation end-products pentosidine and N epsilon-carboxymethyllysine are elevated in serum of patients with osteoporosis. Rheumatology (Oxford) 2003;42:1242-6.
19. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of Vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 2007;92:2017-29.
20. Wientroub S, Eisenberg D, Tardiman R, Weissman SL, Salama R. Is diabetic osteoporosis due to microangiopathy? Lancet 1980;316:983.
21. Vogt MT, Cauley JA, Kuller LH, Nevitt MC. Bone mineral density and blood flow to the lower extremities: The study of osteoporotic fractures. J Bone Miner Res 1997;12:283-9.
22. Kao WH, Kammerer CM, Schneider JL, Bauer RL, Mitchell BD. Type 2 diabetes is associated with increased bone mineral density in Mexican-American women. Arch Med Res 2003;34:399-406.
23. Bonjour JP, Chevalley T, Rizzoli R, Ferrari S. Gene-environment interactions in the skeletal response to nutrition and exercise during growth. Med Sport Sci 2007;51:64-80.
24. Meema HE, Meema S. The relationship of diabetes mellitus and body weight to osteoporosis in elderly females. Can Med Assoc J 1967;96:132.
25. Genant HK, Cooper C, Poor G, Reid I, Ehrlich G, Kanis J, et al. Interim report and recommendations of the World Health Organization task-force for osteoporosis. Osteoporos Int 1999;10:259-64.
26. Tuominen JT, Impivaara O, Puukka P, Rönnemaa TA. Bone mineral density in patients with type 1 and type 2 diabetes. Diabetes Care 1999;22:1196-200.
27. Oei L, Zillikens MC, Dehghan A, Buitendijk GH, Castaño-Betancourt MC, Estrada K, et al. High bone mineral density and fracture risk in type 2 diabetes as skeletal complications of inadequate glucose control: The Rotterdam study. Diabetes Care 2013;36:1619-28.
28. Dutta MK, Pakhetra R, Garg MK. Evaluation of bone mineral density in type 2 diabetes mellitus patients before and after treatment. Med J Armed Forces India 2012;68:48-52.
29. Available from:

How to Cite this article: Caughey WJ, Zaidi F, Shepherd CJ, Rivera-Rodriguez C, Pitto RP. Is Potential Malnutrition Associated with Increased Morbidity in Total Hip and Knee Joint Arthroplasty? A Prospective Cohort Study. Journal of Clinical Orthopaedics 2024 January-June;9(1):04-09.

 (Article Text HTML)       (Download PDF)

Prevalence of Nerve Injuries in Lower Limb following Total Joint Replacement Surgery, and Management

Vol 3 | Issue 2 |  July-Dec 2018 | Page 36-43 | Kunal Ajitkumar Shah, Mohan M Desai.

Authors: Kunal Ajitkumar Shah [1], Mohan M Desai [1].

[1] Department of Orthopaedics, KEM Hospital, Parel Mumbai

Address of Correspondence
Dr. Mohan Desai,
Department of Orthopaedics, KEM Hospital, Parel Mumbai


Nerve injuries during lower limb joint replacement are uncommon but serious complications. Review of this condition is sparse in literature. The present review aims to collate the current literature and provide an overview of the subject. Subclinical cases are quite common and preoperative counseling would be helpful. In case the nerve injury occurs, assurance and counselling helps. Since, the prognosis is not uniform and depends on multiple factors, it is best to try and avoid these iatrogenic injuries. A good surgeon knows how to manage his complications, but the best surgeon knows how to avoid them!
Keywords: Nerve injuries, knee arthroplasty, hip arthroplasty, iatrogenic


1. Ahmad I, Patil S. Isolated deep peroneal (fibular) nerve palsy in association with primary total hip arthroplasty. Clin Anat 2007;20:703–4.
2. Brown GD, Swanson EA, Nercessian OA. Neurologic injuries after total hip arthroplasty. Am J Orthop (Belle Mead NJ) 2008;37:191–7.
3. Farrell CM, Springer BD, Haidukewych GJ, Morrey BF. Motor nerve palsy following primary total hip arthroplasty. J Bone Joint Surg Am 2005;87:2619–25.
4. Navarro R. Surgical Approach and Nerve Palsy in Total. J Arthroplasty 1995;10:1–5.
5. Nercessian OA, Piccoluga F, Eftekhar NS. Postoperative sciatic and femoral nerve palsy with reference to leg lengthening and medialization/lateralization of the hip joint following total hip arthroplasty. Clin Orthop Relat Res 1994:165–71.
6. Edwards BN, Tullos HS, Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop Relat Res 1987:136–41.
7. Idusuyi OB, Morrey BF. Peroneal nerve palsy after total knee arthroplasty. J Bone Jt Surg 1996;78:177–84.
8. Asp JP, Rand JA. Peroneal nerve palsy after total knee arthroplasty. Clin Orthop Relat Res 1990:233–7.
9. 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;64:347–51.
10. Horlocker TT, Cabanela ME, Wedel DJ. Does postoperative epidural analgesia increase the risk of peroneal nerve palsy after total knee arthroplasty? Anesth Analg 1994;79:495–500.
11. Coventry MB, Upshaw JE, Riley LH, Finerman GA, Turner RH. Geometric total knee arthroplasty. II. Patient data and complications. Clin Orthop Relat Res n.d.:177–84.
12. Park JH, Hozack B, Kim P, Norton R, Mandel S. Common Peroneal Nerve Palsy Following Total Hip Arthroplasty : Prognostic Factors for Recovery 2013;55:5–9.
13. Schinsky MF, Macaulay W, Parks ML, Kiernan H, Nercessian OA. Nerve injury after primary total knee arthroplasty. J Arthroplasty 2001;16:1048–54. doi:10.1054/arth.2001.26591.
14. Kaushal SP, Galante JO, McKenna R, Bachmann F. Complications following total knee replacement. Clin Orthop Relat Res 1976:181–7.
15. Weale AE, Newman P, Ferguson IT, Bannister GC. Nerve injury after posterior and direct lateral approaches for hip replacement. A clinical and electrophysiological study. J Bone Joint Surg Br 1996;78:899–902.
16. Weber ER, Daube JR, Coventry MB. Peripheral neuropathies associated with total hip arthroplasty. J Bone Joint Surg Am 1976;58:66–9.
17. Schmalzried TP, Amstutz HC, Dorey FJ. Nerve palsy associated with total hip replacement. Risk factors and prognosis. J Bone Joint Surg Am 1991;73:1074–80.
18. Nercessian OA, Macaulay W, Stinchfield FE. Peripheral neuropathies following total hip arthroplasty. J Arthroplasty 1994;9:645–51.
19. Johanson NA, Pellicci PM, Tsairis P, Salvati EA. Nerve injury in total hip arthroplasty. Clin Orthop Relat Res 1983:214–22.
20. Borrelli J, Kantor J, Ungacta F, Ricci W. Intraneural sciatic nerve pressures relative to the position of the hip and knee: a human cadaveric study. J Orthop Trauma 2000;14:255–8.
21. Fleming RE, Michelsen CB, Stinchfield FE. Sciatic paralysis. A complication of bleeding following hip surgery. J Bone Joint Surg Am 1979;61:37–9.
22. Wang T-I, Chen H-Y, Tsai C-H, Hsu H-C, Lin T-L. Distances between bony landmarks and adjacent nerves: anatomical factors that may influence retractor placement in total hip replacement surgery. J Orthop Surg Res 2016;11:31.
23. Hurd JL, Potter HG, Dua V, Ranawat CS. Sciatic nerve palsy after primary total hip arthroplasty: a new perspective. J Arthroplasty 2006;21:796–802. doi:10.1016/j.arth.2005.08.008.
24. Pokorný D, Jahoda D, Veigl D, Pinskerová V, Sosna A. Topographic variations of the relationship of the sciatic nerve and the piriformis muscle and its relevance to palsy after total hip arthroplasty. Surg Radiol Anat 2006;28:88–91.
25 Solheim LF, Hagen R. Femoral and sciatic neuropathies after total hip arthroplasty. Acta Orthop Scand 1980;51:531–4.
26. Cohen DE, Van Duker B, Siegel S, Keon TP. Common peroneal nerve palsy associated with epidural analgesia. Anesth Analg 1993;76:429–31.
27. Xu L, Veeravagu A, Azad T, Harraher C, Ratliff J. Delayed Presentation of Sciatic Nerve Injury after Total Hip Arthroplasty: Neurosurgical Considerations, Diagnosis, and Management. J Neurol Surg Reports 2016;77:e134–8.
28. Pandey P, Pawar I. Postoperative Total Sciatic Nerve Palsy After Cemented Bipolar Hemi-arthroplasty : Sciatic Nerve Found Sutured With Capsule 2015;14:7–9.
29. Neves P. Compressive Iliac Aneurysm: A Rare Case of Sciatic Nerve Palsy after Total Hip Replacement. MOJ Orthop Rheumatol 2016;4:4–6.
30. Highet WB, Holmes W. Traction injuries to the lateral popliteal nerve and traction injuries to peripheral nerves after suture. Br J Surg 1943;30:212–33. .
32. Lundborg G, Rydevik B. Effects of stretching the tibial nerve of the rabbit. A preliminary study of the intraneural circulation and the barrier function of the perineurium. J Bone Joint Surg Br 1973;55:390–401.
33. Bryan RS, Peterson LF, Combs JJ. Polycentric knee arthroplasty. A preliminary report of postoperative complications in 450 knees. Clin Orthop Relat Res n.d.:148–52.
34. Insall JN, Ranawat CS, Aglietti P, Shine J. A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg Am 1976;58:754–65.
35. Miyasaka KC, Ranawat CS, Mullaji A. 10- to 20-year followup of total knee arthroplasty for valgus deformities. Clin Orthop Relat Res 1997:29–37.
36. Webster DA, Murray DG. Complications of Variable Axis total knee arthroplasty. Clin Orthop Relat Res 1985:160–7.
37. Bruzzone M, Ranawat A, Castoldi F, Dettoni F, Rossi P, Rossi R. The Risk of Direct Peroneal Nerve Injury Using the Ranawat “Inside-Out” Lateral Release Technique in Valgus Total Knee Arthroplasty. J Arthroplasty 2010;25:161–5.
38. Knutson K, Leden I, Sturfelt G, Rosen I, Lidgren L. Nerve palsy after knee arthroplasty in patients with rheumatoid arthritis. Scand J Rheumatol 1983;12:201–5.
39. Weingarden SI, Louis DL, Waylonis GW. Electromyographic changes in postmeniscectomy patients. Role of the pneumatic tourniquet. JAMA 1979;241:1248–50.
40. Wakai A, Winter DC, Street JT, Redmond PH. Pneumatic tourniquets in extremity surgery. J Am Acad Orthop Surg n.d.;9:345–51.
41. Gomez D, Sidhu S, Jha K. Femoral And Saphenous Nerve Palsy Post-Total Knee Replacement 2005;3:1–4.
42. Dobner JJ, Nitz AJ. Postmeniscectomy tourniquet palsy and functional sequelae. Am J Sports Med 1982;10:211–4.
44. Rorabeck CH, Kennedy JC. Tourniquet-induced nerve ischemia complicating knee ligament surgery. Am J Sports Med 1980;8:98–102..
45. Ochoa J, Fowler TJ, Gilliatt RW. Anatomical changes in peripheral nerves compressed by a pneumatic tourniquet. J Anat 1972;113:433–55.
46. Bruner JM. Time, pressure, and temperature factors in the safe use of the tourniquet. Hand 1970;2:39–42.
47. Heppenstall RB, Balderston R, Goodwin C. Pathophysiologic effects distal to a tourniquet in the dog. J Trauma 1979;19:234–8.
48. Klenerman L. Tourniquet time — How long? Hand 1980;12:231–4.
49. Olivecrona C, Blomfeldt R, Ponzer S, Stanford BR, Nilsson BY. Tourniquet cuff pressure and nerve injury in knee arthroplasty in a bloodless field: A neurophysiological study. Acta Orthop 2013;84:159–64.
50. Pedowitz RA, Gershuni DH, Schmidt AH, Fridén J, Rydevik BL, Hargens AR. Muscle injury induced beneath and distal to a pneumatic tourniquet: a quantitative animal study of effects of tourniquet pressure and duration. J Hand Surg Am 1991;16:610–21.
51. Upton AR, McComas AJ. The double crush in nerve entrapment syndromes. Lancet (London, England) 1973;2:359–62.
52. Jacob AK, Mantilla CB, Sviggum HP, Schroeder DR, Pagnano MW, Hebl JR. Perioperative Nerve Injury after Total Knee Arthroplasty. Anesthesiology 2011;114:311–7.
53. Shetty T, Nguyen JT, Sasaki M, Wu A, Bogner E, Burge A, et al. Risk factors for acute nerve injury after total knee arthroplasty. Muscle Nerve 2018.
54. Su EP. HIP ARTHROPLASTY : AVOIDING AND MANAGING PROBLEMS Retraction : Post-operative neuropathy after total hip arthroplasty n.d.:46–9.
55. Fine M De, Romagnoli M, Zaffagnini S, Pignatti G. Sciatic Nerve Palsy following Total Hip Replacement : Are Patients Personal Characteristics More Important than Limb Lengthening ? A Systematic Review 2017;2017.
56. Sakai T, Sugano N, Fujii M, Nishii T, Ohzono K, Yoshikawa H. Sciatic nerve palsy after cementless total hip arthroplasty. Treatment by modular neck and calcar shortening: A case report. J Orthop Sci 2002;7:400–2.
57. Schmalzried TP, Noordin S, Amstutz HC. Update on nerve palsy associated with total hip replacement. Clin Orthop Relat Res 1997:188–206.
58. Macheras GA, Christofilopoulos P, Lepetsos P, Leonidou AO, Anastasopoulos PP, Galanakos SP. Nerve injuries in total hip arthroplasty with a mini invasive anterior approach. HIP Int 2016;26:338–43. doi:10.5301/hipint.5000352.
59. Pekkarinen J, Alho A, Puusa A, Paavilainen T. Recovery of sciatic nerve injuries in association with total hip arthroplasty in 27 patients. J Arthroplasty 1999;14:305–11.
60. SUNDERLAND S. Blood supply of the sciatic nerve and its popliteal divisions in man. Arch Neurol Psychiatry 1945;54:283–9.
61. Unwin A, Scott J. Nerve palsy after hip replacement: Medico-legal implications. Int Orthop 1999;23:133–7.
62. Simmons C, Izant TH, Rothman RH, Booth RE, Balderston RA. Femoral neuropathy following total hip arthroplasty. Anatomic study, case reports, and literature review. J Arthroplasty 1991;6 Suppl:S57-66.
63. Miozzari HH, Dora C, Clark JM, Nötzli HP. Late repair of abductor avulsion after the transgluteal approach for hip arthroplasty. J Arthroplasty 2010;25:450–457.e1.
64. Weber M, Berry DJ. Abductor avulsion after primary total hip arthroplasty. Results of repair. J Arthroplasty 1997;12:202–6.
65. Hendry J, Biant LC, Breusch SJ. Abductor mechanism tears in primary total hip arthroplasty. Arch Orthop Trauma Surg 2012;132:1619–23.
66. Grossman MG, Ducey SA, Nadler SS, Levy AS. Meralgia paresthetica: diagnosis and treatment. J Am Acad Orthop Surg n.d.;9:336–44.
67. Coert JH, Dellon AL. Documenting Neuropathy of the Lateral Femoral Cutaneous Nerve Using the Pressure-Specified Sensory Testing Device. Ann Plast Surg 2003;50:373–7. doi:10.1097/01.SAP.0000041483.93122.58.
68. Barton C, Kim PR. Complications of the Direct Anterior Approach for Total Hip Arthroplasty. Orthop Clin North Am 2009;40:371–5. doi:10.1016/j.ocl.2009.04.004.
69. Goulding K, Beaule PE, Kim PR, Ma AF. Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty 2010:2397–404. doi:10.1007/s11999-010-1406-5.
70. Bender B, Nogler M, Hozack WJ. Direct anterior approach for total hip arthroplasty. Orthop Clin North Am 2009;40:321–8. .
71. GIBSON A. Posterior exposure of the hip joint. J Bone Joint Surg Br 1950;32–B:183–6.
72. Ling ZX, Kumar VP. The course of the inferior gluteal nerve in the posterior approach to the hip n.d.:1580–3. doi:10.1302/0301-620X.88B12.18182.
73. Henningsen MH, Jæger P, Hilsted KL, Dahl JB. Nerve injury and adductor-canal-blockade. Acta Anaesthesiol Scand 2013;57:112–7.
74. Siliski JM, Scott RD. Obturator-nerve palsy resulting from intrapelvic extrusion of cement during total hip replacement. Report of four cases. J Bone Joint Surg Am 1985;67:1225–8.
75. Wolf M, Bäumer P, Pedro M, Dombert T, Staub F, Heiland S, et al. Sciatic Nerve Injury Related to Hip Replacement Surgery: Imaging Detection by MR Neurography Despite Susceptibility Artifacts. PLoS One 2014;9:e89154. .
76. Chhabra A, Andreisek G, Soldatos T, Wang KC, Flammang AJ, Belzberg AJ, et al. MR neurography: Past, present, and future. Am J Roentgenol 2011;197:583–91. doi:10.2214/AJR.10.6012.
77. Engelbrecht E, Siegel A, ROTTGER J, Buchholz HW. Statistics of total knee replacement: partial and total knee replacement, design St. Georg: a review of a 4-year observation. Clin Orthop Relat Res 1976:54–64.
78. Clawson DK, Seddon HJ. THE RESULTS OF REPAIR OF THE SCIATIC NERVE. J Bone Joint Surg Br 1960;42–B:205–12.
79. Ulrich SD, Bhave A, Marker DR, Seyler TM, Mont MA. Focused rehabilitation treatment of poorly functioning total knee arthroplasties. Clin Orthop Relat Res 2007;464:138–45.
80. Krackow KA, Maar DC, Mont MA, Carroll C. Surgical decompression for peroneal nerve palsy after total knee arthroplasty. Clin Orthop Relat Res 1993:223–8.
81. MONT MA, DELLON AL, CHEN F, HUNGERFORD MW, KRACKOW KA, HUNGERFORD DS. The Operative Treatment of Peroneal Nerve Palsy*. J Bone Jt Surg 1996;78:863–9.
82. Wilson TJ, Kleiber GM, Nunley RM, Mackinnon SE, Spinner RJ. Distal peroneal nerve decompression after sciatic nerve injury secondary to total hip arthroplasty. J Neurosurg 2018:1–5.
83. Regev GJ, Drexler M, Sever R, Dwyer T, Khashan M, Lidar Z, et al. Neurolysis for the treatment of sciatic nerve palsy associated with total hip arthroplasty. Bone Joint J 2015;97–B:1345–9.
84. Lavigne MJ, Sanchez AA, Coutts RD. Recurrent dislocation after total hip arthroplasty: treatment with an Achilles tendon allograft. J Arthroplasty 2001;16:13–8.
85. DeHart MM, Riley LH. Nerve injuries in total hip arthroplasty. J Am Acad Orthop Surg n.d.;7:101–11.
86. Omar NB, Ditty BJ, Rozzelle CJ. Medicolegal Aspects of Peripheral Nerve Injury. Nerves Nerve Inj., Elsevier; 2015, p. 707–8.
87. Bhutta MA, Arshad MS, Hassan S, Henderson JJ. Trends in joint arthroplasty litigation over five years: The British experience. Ann R Coll Surg Engl 2011;93:460–4.
88. padhyay A, York S, Macaulay W, McGrory B, Robbennolt J, Bal BS. Medical Malpractice in Hip and Knee Arthroplasty. J Arthroplasty 2007;22.

How to Cite this article: Shah K, Desai M. Prevalence of Nerve Injuries in Lower Limb following Total Joint Replacement Surgery, and Management. Journal of Clinical Orthopaedics July-Dec 2018; 3(2):36-43.

(Abstract    Full Text HTML)      (Download PDF)