Peroneal nerve injury associated with sports-related knee injury

2011 ◽  
Vol 31 (5) ◽  
pp. E11 ◽  
Author(s):  
Dosang Cho ◽  
Kriangsak Saetia ◽  
Sangkook Lee ◽  
David G. Kline ◽  
Daniel H. Kim
Keyword(s):  
Nerve Injury ◽  
Peroneal Nerve ◽  
Nerve Repair ◽  
Knee Injuries ◽  
Ice Hockey ◽  
Fracture Dislocation ◽  
Nerve Injuries ◽  
Surgical Interventions ◽  
Peroneal Nerve Injury ◽  
Graft Length

Object This study analyzes 84 cases of peroneal nerve injuries associated with sports-related knee injuries and their surgical outcome and management. Methods The authors retrospectively reviewed the cases of peroneal nerve injury associated with sports between the years 1970 and 2010. Each patient was evaluated for injury mechanism, preoperative neurological status, electrophysiological studies, lesion type, and operative technique (neurolysis and graft repair). Preoperative status of injury was evaluated by using a grading system published by the senior authors. All lesions in continuity had intraoperative nerve action potential recordings. Results Eighty-four (approximately 18%) of 448 cases of peroneal nerve injury were found to be sports related, which included skiing (42 cases), football (23 cases), soccer (8 cases), basketball (6 cases), ice hockey (2 cases), track (2 cases) and volleyball (1 case). Of these 84 cases, 48 were identified as not having fracture/dislocation and 36 cases were identified with fracture/dislocation for surgical interventions. Good functional outcomes from graft repair of graft length < 6 cm (70%) and neurolysis (85%) in low-intensity peroneal nerve injuries associated with sports were obtained. Recovery from graft repair of graft length between 6 and 12 cm (43%) was good and measured between Grades 3 and 4. However, recovery from graft repair of graft length between 13 and 24 cm was obtained in only 25% of patients. Conclusions Traumatic knee-level peroneal nerve injury due to sports is usually associated with stretch/contusion, which more often requires graft repair. Graft length is the factor to be considered for the prognosis of nerve repair.

Incidence of Concurrent Peroneal Nerve Injury in Multiligament Knee Injuries and Outcomes after Knee Reconstruction

2018 ◽  
Vol 32 (06) ◽  
pp. 560-564 ◽  
Author(s):  
John R. Worley ◽  
Olubusola Brimmo ◽  
Clayton W. Nuelle ◽  
James L. Cook ◽  
James P. Stannard
Keyword(s):  
Return To Work ◽  
Nerve Injury ◽  
Peroneal Nerve ◽  
Knee Injuries ◽  
Knee Reconstruction ◽  
Level Of Activity ◽  
Previous Level ◽  
Peroneal Nerve Injury ◽  
Multiligament Knee Injuries

AbstractThe purpose of this study was to determine incidence of concurrent peroneal nerve injury and to compare outcomes in patients with and without peroneal nerve injury after surgical treatment for multiligament knee injuries (MLKIs). A retrospective study of 357 MLKIs was conducted. Patients with two or more knee ligaments requiring surgical reconstruction were included. Mean follow-up was 35 months (0–117). Incidence of concurrent peroneal nerve injury was noted and patients with and without nerve injury were evaluated for outcomes. Concurrent peroneal nerve injury occurred in 68 patients (19%). In patients with nerve injury, 45 (73%) returned to full duty at work; 193 (81%) patients without nerve injury returned to full duty (p = 0.06). In patients with nerve injury, 37 (60%) returned to their previous level of activity; 148 (62%) patients without nerve injury returned to their previous level of activity (p = 0.41). At final follow-up, there were no significant differences in level of pain (mean visual analog scale 1.6 vs. 2; p = 0.17), Lysholm score (mean 88.6 vs. 88.8; p = 0.94), or International Knee Documentation Committee score (mean 46.2 vs. 47.8; p = 0.67) for patients with or without peroneal nerve injury, respectively. Postoperative range of motion (ROM) (mean 121 degrees) was significantly lower (p = 0.02) for patients with nerve injury compared with patients without nerve injury (mean 127 degrees). Concurrent peroneal nerve injury occurred in 19% of patients in this large cohort suffering MLKIs. After knee reconstruction surgery, patients with concurrent peroneal nerve injuries had significantly lower knee ROM and trended toward a lower rate of return to work. However, outcomes with respect to activity level, pain, and function were not significantly different between the two groups. This study contributes to our understanding of patient outcomes in patients with concurrent MLKI and peroneal nerve injury, with a focus on the patient's ability to return to work and sporting activity.

scholarly journals Immediate or Delayed Transplantation of a Vein Conduit Filled with Nasal Olfactory Stem Cells Improves Locomotion and Axogenesis in Rats after a Peroneal Nerve Loss of Substance

2020 ◽  
Vol 21 (8) ◽  
pp. 2670
Author(s):  
Maxime Bonnet ◽  
Gaëlle Guiraudie-Capraz ◽  
Tanguy Marqueste ◽  
Stéphane Garcia ◽  
Charlotte Jaloux ◽  
...  
Keyword(s):  
Stem Cells ◽  
Nerve Injury ◽  
Peroneal Nerve ◽  
Therapeutic Potential ◽  
Femoral Vein ◽  
Nerve Repair ◽  
Control Group ◽  
Muscle Properties ◽  
Locomotor Recovery ◽  
Peroneal Nerve Injury

Over the recent years, several methods have been experienced to repair injured peripheral nerves. Among investigated strategies, the use of natural or synthetic conduits was validated for clinical application. In this study, we assessed the therapeutic potential of vein guides, transplanted immediately or two weeks after a peroneal nerve injury and filled with olfactory ecto-mesenchymal stem cells (OEMSC). Rats were randomly allocated to five groups. A3 mm peroneal nerve loss was bridged, acutely or chronically, with a 1 cm long femoral vein and with/without OEMSCs. These four groups were compared to unoperated rats (Control group). OEMSCs were purified from male olfactory mucosae and grafted into female hosts. Three months after surgery, nerve repair was analyzed by measuring locomotor function, mechanical muscle properties, muscle mass, axon number, and myelination. We observed that stem cells significantly (i) increased locomotor recovery, (ii) partially maintained the contractile phenotype of the target muscle, and (iii) augmented the number of growing axons. OEMSCs remained in the nerve and did not migrate in other organs. These results open the way for a phase I/IIa clinical trial based on the autologous engraftment of OEMSCs in patients with a nerve injury, especially those with neglected wounds.

scholarly journals The Multiligament Knee Injury Classification Stratifies Patients into Risk Categories

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0049
Author(s):  
Patrick Huang ◽  
Don Li ◽  
Logan Petit ◽  
Jack Porrino ◽  
Michael Medvecky ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Vascular Injury ◽  
Peroneal Nerve ◽  
Knee Injuries ◽  
Knee Dislocation ◽  
Associated Injuries ◽  
Injury Patterns ◽  
Ligamentous Injury ◽  
Peroneal Nerve Injury ◽  
Multiligament Knee Injuries

Objectives: Our goal was to characterize the precise ligamentous injury locations and patterns of acute multi-ligament knee injuries (MLKI) and determine associated rates of dislocations, fractures, peroneal nerve palsies, and vascular injuries. Methods: All patients at a single level one trauma center who received operative treatment for MLKI between 2001 and 2019 were retrospectively identified. Demographic, injury mechanism, injury patterns, presence of dislocation, and associated injuries including vascular injury, peroneal nerve palsy, and fracture were assessed for each patient. MLKI both with and without a document knee dislocation were classified into five classes based on pattern of ligamentous tear (Figure 1). Class 1 included unicruciate tear with any combination of collateral tear. Class 2 are a bicruciate tear without collateral involvement. Class 3 are bicruciate tears with either a medial or lateral sided tear. Class 4 are bicruciate tears with both medial and lateral sided tears. Class 5 are periarticular fracture with any of the preceding ligamentous injury patterns. Rates of dislocation, vascular injury and peroneal nerve injury were analyzed among each class. Single variable statistics such as t-tests as well as multivariable techniques such as Chi square and multiple regression analysis was performed to identify patterns of injury and to predict risk of associated injuries. Results: 100 knees were identified as multiligament knee injuries. 34 of the knees (34%) were dislocated at presentation, and the remaining 66 (66%) did not have a documented knee dislocation. Patients with a documented knee dislocation had higher rates of vascular injury (24% vs. 3%, p = 0.0148), but not higher rates of peroneal nerve injury (32% vs. 20%, p = 0.0863). Patients with PLC injuries had statistically higher rates of peroneal nerve injury compared to acute multiligament knee injuries without a lateral sided injury (30% vs. 3%, p = 0.005). Rates of vascular injury between MLK Class are shown in Table 1. MLK Class was found to be predictive of vascular injury, but not of peroneal nerve injury. Conclusion: We present a new classification of multiligament knee injuries with the goal of providing a more precise diagnosis to aid in the surgical planning and decision making as well as to enhance clinical outcomes research of these complicated injury patterns. By classifying these injuries into five separate classes and further subclassified based on presence of dislocation and lateral sided injury, we are better able to predict likelihood of neurovascular injury. We hope that understanding the risks associated with each class will allow physicians to better appreciate the likelihood of potential complications of these injuries.

scholarly journals Establishment of a Sheep Model for Hind Limb Peripheral Nerve Injury: Common Peroneal Nerve

2021 ◽  
Vol 22 (3) ◽  
pp. 1401
Author(s):  
Rui D. Alvites ◽  
Mariana V. Branquinho ◽  
Ana C. Sousa ◽  
Federica Zen ◽  
Monica Maurina ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Small Sample ◽  
Therapeutic Options ◽  
Nerve Injuries ◽  
Sheep Model ◽  
The Common

Thousands of people worldwide suffer from peripheral nerve injuries and must deal daily with the resulting physiological and functional deficits. Recent advances in this field are still insufficient to guarantee adequate outcomes, and the development of new and compelling therapeutic options require the use of valid preclinical models that effectively replicate the characteristics and challenges associated with these injuries in humans. In this study, we established a sheep model for common peroneal nerve injuries that can be applied in preclinical research with the advantages associated with the use of large animal models. The anatomy of the common peroneal nerve and topographically related nerves, the functional consequences of its injury and a neurological examination directed at this nerve have been described. Furthermore, the surgical protocol for accessing the common peroneal nerve, the induction of different types of nerve damage and the application of possible therapeutic options were described. Finally, a preliminary morphological and stereological study was carried out to establish control values for the healthy common peroneal nerves regarding this animal model and to identify preliminary differences between therapeutic methods. This study allowed to define the described lateral incision as the best to access the common peroneal nerve, besides establishing 12 and 24 weeks as the minimum periods to study lesions of axonotmesis and neurotmesis, respectively, in this specie. The post-mortem evaluation of the harvested nerves allowed to register stereological values for healthy common peroneal nerves to be used as controls in future studies, and to establish preliminary values associated with the therapeutic performance of the different applied options, although limited by a small sample size, thus requiring further validation studies. Finally, this study demonstrated that the sheep is a valid model of peripheral nerve injury to be used in pre-clinical and translational works and to evaluate the efficacy and safety of nerve injury therapeutic options before its clinical application in humans and veterinary patients.

Isokinetic cross-training effect in foot drop following common peroneal nerve injury

2015 ◽  
Vol 23 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Andrea Manca ◽  
Francesco Pisanu ◽  
Enzo Ortu ◽  
Edoardo De Natale ◽  
Francesca Ginatempo ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Training Effect ◽  
Cross Training ◽  
Peroneal Nerve Injury

Iatrogenic common peroneal nerve injury during harvesting of semitendinosus tendon for anterior cruciate ligament reconstruction

2021 ◽  
Vol 14 (4) ◽  
pp. e240736
Author(s):  
Raf Mens ◽  
Albert van Houten ◽  
Roy Bernardus Gerardus Brokelman ◽  
Roy Hoogeslag
Keyword(s):  
Anterior Cruciate Ligament ◽  
Nerve Injury ◽  
Peroneal Nerve ◽  
Cruciate Ligament ◽  
Common Peroneal Nerve ◽  
Peroneal Nerve Injury ◽  
The Common ◽  
Anterior Cruciate ◽  
Incision Technique

We present a case of iatrogenic injury to the common peroneal nerve (CPN) occurring due to harvesting of a hamstring graft, using a posterior mini-incision technique. A twitch of the foot was noted on retraction of the tendon stripper. After clinically diagnosing a CPN palsy proximal to the knee, the patient was referred to a neurosurgeon within 24 hours. An electromyography (EMG) was not obtained since it cannot accurately differentiate between partial and complete nerve injury in the first week after injury. Because the nerve might have been transacted by the tendon stripper, surgical exploration within 72 hours after injury was indicated. An intraneural haematoma was found and neurolysis was performed to decompress the nerve. Functioning of the anterior cruciate ligament was satisfactory during follow-up. Complete return of motor function of the CPN was observed at 1-year follow-up, with some remaining hypoaesthesia.

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