Background

The incidence of neuropathic changes following total knee arthroplasty and its effect on patient satisfaction remains poorly documented.

Objectives
Our aim was to document the incidence of infrapatellar nerve injury following total knee arthroplasty and its effect on patient satisfaction.

Study Design & Methods
Our retrospective study included 120 total knee replacements. Screening of sensory abnormalities was assessed by the DN4 score and the drawing of the topography of sensory disorders in all patients. The functional evaluation was performed by the IKDC score. The data was analysed with SPSS 23.0 software. A p value <0.05 was considered as statically significant.

Results

In this study, we reviewed 98 patients. The mean age was 65.2±7.7 years. We included 79 women and 19 men with a sex ratio of 0.23. The indication of total knee arthroplasty was degenerative osteoarthritis in 95% and osteoarthritis secondary to rheumatoid arthritis in 5%. The incidence of peripatellar neuropathy was noted in 68.3% of patients, regardless of the approach used (antero-medial and sagittal) and the length of the approach. We found a statistically significant correlation between satisfaction and dynamic mechanical pain, also between anterior knee pain and the incidence of altered sensations with p <0.05. Four of our patients felt that an alteration of the skin sensation was a determinant factor in their dissatisfaction.

Conclusions

Sensory changes due to the damage of the infrapatellar branch of the saphenous nerve during total knee joint arthroplasty is a common occurrence and can interfere with patient satisfaction. We recommend that patients should be informed of this risk during the preoperative discussion.