Abstract
The 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.
Keywords
multiligament knee injuries - peroneal nerve injury - range of motion - return to
work - return to activity
