Orthopedic Surgery Expert Witness Advises on Knee Surgery Resulting in Permanent Foot Drop

An orthopedic surgery expert advises on a case involving a woman who suffered from long-term knee pain. The patient was originally taking glucosamine supplements to manage her joint pain, but elected to undergo a total left knee replacement after consulting with her doctor. Within hours of the surgery, plaintiff complained of a numb left foot and had a foot drop. The medical personnel responsible for her post-operative care did not notify the surgeon of her complaint. When the surgeon made his rounds the next day, the plaintiff voiced her concerns. The surgeon told her that her numbness would clear up.

She now has a permanent left foot drop.

She filed suit against the hospital and surgeon alleging negligence for the failure to adhere to accepted standards of care during the surgery and in her post-operative care.

Question(s) For Expert Witness

1. Was the standard of care breached?

2. How was it breached?

Expert Witness Response

I am familiar with the standard of care of orthopedic surgeons in medical and surgical therapy of knee disease including but not limited to total and partial knee replacement surgery and knee revision surgery. I have reviewed plaintiff’s medical records and her physical therapy records.

A month after the initial knee replacement, another surgeon performed:

1. A decompression neuroplasty of plaintiff’s left common peroneal nerve at the level of the fibular head lateral knee.

2. Decompression neuroplasty of the proximal superficial peroneal nerve proximal lateral leg.

3. Decompression neuroplasty of the proximal deep peroneal nerve, proximal anterior compartment.

4. Decompression neuroplasty of the distal superficial peroneal nerve, distal lateral leg.

5. Decompression neuroplasty of distal deep peroneal nerve, dorsum of foot.

6. Tenotomy extensor hallucis brevis tendon. In an attempt to relieve Sabrina's drop foot.

It is my opinion within a reasonable degree of medical certainty that the initial surgeon breached the minimally acceptable standard of care for an orthopedic surgeon in the same or similar situation because:

1. He failed to protect plaintiff’s peroneal nerve.

2. Upon knowledge of her foot drop, he did not immediately identify or take measures to take off the bandages and manipulate or perform decompression surgery on her knee to attempt to relieve the nerve compression.

It is my opinion to a reasonable degree of medical certainty that the surgeon’s breach of the minimally acceptable standard of care for an orthopedic surgeon caused plaintiff to suffer a permanent left foot drop.

The expert is board-certified in orthopedic surgery and teaches at a university medical center.