title: Femoral nerve palsy after arthroscopic surgery with an infusion pump irrigation system. A report of three cases.
abstract: One patient developed complete, and two patients, partial, femoral nerve palsy after arthroscopic surgery in which an infusion pump was used to operate an irrigation system. In one case, hip flexor and quadricep function was completely lost after the patient underwent arthroscopic partial medial meniscectomy without the use of a tourniquet. A CT scan of the pelvis demonstrated considerable fluid accumulation in the thigh and inguinal regions. The remaining two patients developed quadriceps weakness, but not complete femoral nerve palsy, after arthroscopic-assisted anterior cruciate ligament reconstructions. Although tourniquets were used in these latter two procedures, the pressures were low (300 to 325 mm Hg) and the tourniquet times not excessive, suggesting that femoral nerve palsy in these two patients resulted from fluid extravasation. In all three cases, muscle function returned within 6 to 7 months, but sensory nerve deficits were still present at that time.
authors.affiliation: Department of Orthopaedic Surgery, Graduate Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: V J
authors.initials: VJ
authors.lastname: DiStefano
authors.forename: V R
authors.initials: VR
authors.lastname: Kalman
authors.forename: J S
authors.initials: JS
authors.lastname: O'Malley
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000009:adverse effects*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications*; D005267:Femoral Nerve; D006801:Humans; D007260:Infusion Pumps; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D010243:Paralysis / Q000209:etiology*; D010292:Paresthesia / Q000209:etiology; D012865:Skiing / Q000293:injuries; D007507:Therapeutic Irrigation; D014111:Tourniquets