Prevention of common peroneal nerve palsy after surgery for valgus deformity about the knee

Common peroneal nerve palsy after total knee arthroplasty occurs more frequently when there is a preoperative valgus or flexion deformity. There is, however, little information available about the role of nerve release either as a prophylactic procedure or as management of this unfortunate complication when it occurs. A series of nine patients is presented, two of whom underwent exploration for persistent nerve palsy and then had early resolution of neurological function. Another seven patients had prophylactic release at the time of knee arthroplasty. Nerve release was straightforward, associated with minimal morbidity and added little to the duration of surgery. We now perform nerve release at the time of arthroplasty for all but the most minor valgus deformities. (C) 1998 Elsevier Science B.V. All rights reserved.