What is the efficacy of platelet-rich plasma (PRP) injection around the peroneal nerve to treat foot drop following total knee replacement (TKR)?

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From the Research

PRP (platelet-rich plasma) injections around the peroneal nerve for foot drop after total knee replacement have limited evidence of effectiveness and are not currently recommended as a standard treatment. The effectiveness of PRP injections for this specific condition is not well-established. While PRP has shown promise in some orthopedic applications, its use for nerve-related issues like foot drop is still experimental, as seen in a case report from 1. For foot drop after total knee replacement, standard treatments typically include:

  • Physical therapy and exercises to strengthen muscles and improve gait
  • Ankle-foot orthosis (AFO) to support the foot
  • Electrical stimulation to activate muscles
  • In some cases, surgical interventions like nerve decompression or tendon transfer, such as soleus nerve transfer to deep peroneal nerve, which has shown promising results in a retrospective study from 2. If considering PRP, patients should be aware that:
  • Multiple injections may be required
  • Results can vary significantly between individuals
  • It's often not covered by insurance due to limited evidence The theoretical basis for using PRP in nerve injuries is that growth factors in platelets might promote nerve regeneration and reduce inflammation. However, more research is needed to confirm its efficacy specifically for foot drop following knee replacement, as highlighted by a recent case report from 3. Patients experiencing foot drop should consult with their orthopedic surgeon or a neurologist to discuss evidence-based treatment options tailored to their specific situation.

References

Research

Soleus nerve transfer to deep peroneal nerve for treatment of foot drop.

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 2020

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