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Cambios neurofisiológicos asociados a la corrección del genu valgo con prótesis total de rodilla.

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Title: Cambios neurofisiológicos asociados a la corrección del genu valgo con prótesis total de rodilla.
Alternate Title: Neurophysiological changes after correction of valgus deformity with total knee artrhoplasty.
Authors: Aparicio, G.1,2 aparicio22021@gmail.com, Martin-Albarrán, S.1,3, Cortés-Bonilla, R.1,3, Rubias-Ramos, C.1,4, Pérez-Ruiz, P.1,5, García-Crespo, R.1,2, Marco-Martínez, F.1,2
Source: Acta Ortopédica Mexicana. May/Jun2026, Vol. 40 Issue 3, p156-163. 8p.
Subjects: Peroneal nerve, Neurophysiology, Electromyography, Leg length inequality, Nerve conduction studies, Total knee replacement, Entrapment neuropathies
Abstract (English): Objective: we aimed to search for a correlation between neurophysiological changes in the anatomic distribution of the common peroneal nerve (CPN) and the degrees of valgus deformity correction after total knee arthroplasty (TKA). Material and methods: a prospective cohort study of 23 patients was conducted. A preoperative and at one and six months postoperative neurophysiological studies of the CPN were performed. Subsequently, the association between the pathologic neurophysiological findings found (polyphasicity, motor unit loss, low amplitude of evoked potentials) with the degrees of deformity correction and the limb length difference after TKA was analyzed. Results: sixteen of 23 patients completed the study. The mean valgus deformity correction was 9.3o, and the mean lower limb length difference was +10,1 mm. One-month postoperative electromyogram (EMG) was normal in seven patients while the other nine patients showed some findings that normalized at six months. In three patients, mild findings remained. As to electroneurogram (ENG), in all cases there were normal sensory and motor conduction velocities even though thirteen patients showed changes compatible with neurapraxia in different degrees of severity. At six months all patients showed normal values, except one. In any case, there was no clinical sign of major sensory or motor loss in the distribution of the CPN. No statistical correlation could be found between neurophysiological findings and the degrees of valgus deformity correction. Conclusion: we could not find a correlation between neurophysiological changes and the degrees of valgus deformity correction or leg length difference. A threshold of valgus deformity correction indicating prophylactic common peroneal nerve decompression could not be established. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Objetivo: correlacionar los cambios neurofisiológicos en el territorio inervado por el nervio peroneus communis o ciático poplíteo externo (CPE) con los grados de corrección de la deformidad de genu valgo mediante prótesis de rodilla (PTR). Material y métodos: estudio prospectivo de cohorte de 23 pacientes. Se realizó estudio neurofisiológico del CPE preoperatorio y postoperatorio al mes y seis meses. Después se analizó la asociación entre la corrección de la deformidad, la diferencia de longitud del miembro intervenido y las variables neurofisiológicas que presentaron hallazgos considerados patológicos (polifasia, pérdida de unidades motoras, disminución de la amplitud de los potenciales evocados). Resultados: dieciséis de 23 pacientes completaron el estudio. La corrección de la deformidad fue de 9.3o de media y la diferencia de longitud +10.1 mm de media. En el electromiograma al mes de la cirugía, siete pacientes no mostraron anomalías, los otros nueve presentaron algún tipo de hallazgo, se normalizaron a los seis meses. En tres pacientes se mantuvieron hallazgos leves. En cuanto al electroneurograma (ENG), las velocidades de conducción motora y sensitiva fueron normales en todos los casos, aunque trece pacientes mostraron anomalías compatibles con neuroapraxia de distinto grado de severidad. A los seis meses, todos los/las pacientes presentaron valores normales salvo uno. En ningún caso hubo clínica de parálisis del CPE. No hubo correlación estadística de los hallazgos neurofisiológicos con la magnitud de corrección de la deformidad. Conclusiones: no hemos hallado correlación entre los hallazgos del estudio neurofisiológico, ni con la magnitud de la corrección de la deformidad, ni con la diferencia de longitud de los miembros inferiores, por lo que no hemos podido determinar el umbral de deformidad en valgo que indicaría una liberación profiláctica del CPE. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Objective: we aimed to search for a correlation between neurophysiological changes in the anatomic distribution of the common peroneal nerve (CPN) and the degrees of valgus deformity correction after total knee arthroplasty (TKA). Material and methods: a prospective cohort study of 23 patients was conducted. A preoperative and at one and six months postoperative neurophysiological studies of the CPN were performed. Subsequently, the association between the pathologic neurophysiological findings found (polyphasicity, motor unit loss, low amplitude of evoked potentials) with the degrees of deformity correction and the limb length difference after TKA was analyzed. Results: sixteen of 23 patients completed the study. The mean valgus deformity correction was 9.3o, and the mean lower limb length difference was +10,1 mm. One-month postoperative electromyogram (EMG) was normal in seven patients while the other nine patients showed some findings that normalized at six months. In three patients, mild findings remained. As to electroneurogram (ENG), in all cases there were normal sensory and motor conduction velocities even though thirteen patients showed changes compatible with neurapraxia in different degrees of severity. At six months all patients showed normal values, except one. In any case, there was no clinical sign of major sensory or motor loss in the distribution of the CPN. No statistical correlation could be found between neurophysiological findings and the degrees of valgus deformity correction. Conclusion: we could not find a correlation between neurophysiological changes and the degrees of valgus deformity correction or leg length difference. A threshold of valgus deformity correction indicating prophylactic common peroneal nerve decompression could not be established. [ABSTRACT FROM AUTHOR]
ISSN:23064102
DOI:10.35366/123285