| 제목 |
Ischemic Monomelic Neuropathy : a Rare Complication after Total Knee Replacement Arthroplasty |
| 소속 |
Department of Rehabilitation Medicine, College of Medicine, Dankook University1, Department of Nanobiomedical Science & BK21 PLUS NBM Research Center for Regenerative Medicine, Dankook University2, Institute of Tissue Regeneration Engineering(ITREN), Dankook University3 |
| 저자 |
Byung Wook Kim1*, Jung Keun Hyun1,2, Ja-Young Moon1, Tae Uk Kim1† |
Introduction
Ischemic monomelic neuropathy(IMN) is defined as a type of multiple axonal-loss mononeuropathy distally in a limb, resulting from proximal acute occlusion in a major artery. Diabetes, atherosclerotic disease and women have an increased risk of IMN. A few case studies have been documented IMN in upper or lower extremity, but most of them were occurred after vascular access procedure in patients with pre-existing vascular disease such as diabetes, peripheral arterial occlusive disease. In this study, we report a case of IMN in lower extremity resulting from acute popliteal artery occlusion after total knee replacement arthroplasty(TKRA) in patient with no history of diabetes or peripheral arterial disease.
Case presentation
This 74-year-old woman with no history of dibetes or other peripheral arterial diseases visited a orthopedic surgeon for TKRA due to degenerative arthritis in right knee joint. Immediately after TKRA, she developed sudden weakness on right lower leg with painful tingling and numbness. After the next three days, she was diagnosed with right popliteal artery occlusion via computed tomography angiography and underwent thrombectomy. Nerve conduction studies performed 3 weeks postoperatively showed absent responses to sensory and motor nerve stimulation. Reduced or absent motor unit recruitment is found on needle electromyography(EMG), but no abnormal spontaneous activities(ASAs). EMG examination one half months later showed moderate ASAs, but nerve conduction studies were stationary state.
Conclusion
Although one has no pre-existing vascular disease such as diabetes, peripheral arterial occlusive disease, IMN can occur in lower extremity resulting from acute popliteal artery occlusion after TKRA. |
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