title: Restless legs syndrome in subjects with a knee prosthesis: evidence that symptoms are generated in the periphery.
abstract: OBJECTIVE
  There are no data adressing the prevalence of restless legs syndrome in subjects who have knee prosthesis. Therefore, we conducted a cross-sectional survey of subjects who underwent knee prosthesis surgery.
  
  
  METHODS
  A total of 107 subjects (30 male, 77 female) were interviewed over the telephone regarding restless legs syndrome symptoms. If the patients exhibited symptoms of the syndrome, we conducted face-to-face interviews. Lastly, a therapeutic test with pramipexole was proposed for each subject.
  
  
  RESULTS
  In our cohort, 7 males (23%) and 30 females (39%) had restless legs syndrome. Of these, 6 males and 23 females were submitted to face-to-face-interview. Of the males, 5 (83%) had restless legs after the knee surgery-exclusively in the operated leg- and reported no family restless legs history. One man had a prior case of bilateral restless legs syndrome, a positive family history and claimed exacerbation of symptoms in the operated leg. Among the females, 16 (69%) had restless legs prior to surgery. A total of 10 female patients reported bilateral symptoms, with fewer symptoms in the operated leg, while 6 displayed a worse outcome in the operated leg. The 7 females (31%) without restless legs prior to surgery and without a family history experienced symptoms only in the operated leg. All subjects responded favorably to the pramipexole therapeutic test.
  
  
  CONCLUSIONS
  Our results suggest that secondary unilateral restless legs syndrome may ensue from knee prosthesis surgery and that the symptoms are generated in the peripheral nervous system.
authors.affiliation: Faculdade de Medicina de Jundiaí, Pediatria, Jundiaí, SP, Brazil. joscarlospereirajr@gmail.com
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Pereira
authors.forename: João Luiz Pereira da
authors.initials: JL
authors.lastname: Silva Neto
authors.forename: Márcia
authors.initials: M
authors.lastname: Pradella-Hallinan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D052160:Benzothiazoles / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005192:Family Health / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D010543:Peroneal Nerve / Q000293:injuries*; D000077487:Pramipexole; D012148:Restless Legs Syndrome / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D017678:Sex Distribution
chemical_list: D018726:Anti-Dyskinesia Agents; D052160:Benzothiazoles; D000077487:Pramipexole
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