The patient was able to actively flex and extend the knee. There was active plantar flexion and inversion but hyperesthesia about the plantar aspect with positive TinelвЂ™s over the tarsal tunnel. The sensation was diminished over the dorsum of the foot. TinelвЂ™s and scratch collapse about the fibular head were positive. There was no voluntary dorsiflexion or eversion. On physical examination, she was found to have left common peroneal nerve deficits and paresthesia in the tibial nerve distribution. However, she developed pain and paresthesia about the foot and weakness of the ankle within hours after surgery that was attributed to tibial and common peroneal nerve palsies, while plantar flexion, inversion, and sensation improved to the plantar aspects of the foot with the return of tibial nerve function, pain, paresthesia, and weakness in dorsiflexion and eversion persisted in the superficial and deep peroneal nerve distributions. She reported preserved plantar flexion and dorsiflexion immediately postoperatively. Case ReportДЄ 56-year-old woman presented to our institution 16 months after undergoing a left TKA at an unaffiliated facility with left lower extremity pain, paresthesia, and foot drop that developed postoperatively. Here, we present a case of ischemic contracture of the anterior and lateral compartments of the leg as sequelae of compartment syndrome following elective TKA 16 months prior to presentation. Treatment of compartment syndrome is emergent fasciotomy of the involved compartments to prevent irreversible neurologic and muscle ischemia. Postoperative analgesia may delay diagnosis, as it can mask clinical symptoms. Compartment syndrome following TKA is frequently misdiagnosed as deep vein thrombosis, peroneal nerve palsy, or postoperative swelling. The length of time from TKA to the development of symptoms has been reported to range from hours to 1 week. Д¬ompartment syndrome following elective total knee arthroplasty (TKA) is rare, primarily reported in case reports and small series.

The majority (80%) of these cases are the result of musculoskeletal trauma, typically to the lower leg. The estimated annual incidence of compartment syndrome is 1вЂ“7.3 per 100,000. Compartment syndrome occurs when interstitial pressure within an anatomic compartment exceeds perfusion pressure and can result in ischemia causing nerve and muscle damage.

Compartments of leg knee