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Neurological Rehabilitation

Guillain-Barre Syndrome following total knee arthroplasty, a case report

Saturday, October 25, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 6

    Poster Presenter(s)

  • Andres Gronda, MD

    Resident
    New York University Grossman School of Medicine PM&R Program
    New York, New York

    • Co-Author(s)

  • Sidharth Sahni, DO

    PGY-2
    New York University Grossman School of Medicine PM&R Program
    New York, New York

  • Hannah Park, DO

    Resident
    New York University Grossman School of Medicine PM&R Program
    New York, New York

  • JL

    Jing Lin, MD

    Assistant professor
    New York University Grossman School of Medicine PM&R Program
    New York, New York

Disclosure(s):
Andres Gronda, MD: No financial relationships to disclose
Sidharth Sahni, DO: No financial relationships to disclose
Hannah Park, DO: No financial relationships to disclose
Case Diagnosis: 65-year-old male developed Guillain-Barre Syndrome (GBS) after a left total knee arthroplasty (TKA).

Case Description or Program Description: A 65-year-old male with a past medical history of hypertension, sleep apnea, and bilateral knee osteoarthritis underwent a left total knee arthroplasty with no documented operative or immediate post-operative complications. Nineteen days after surgery, he presented to an emergency department with one week of fatigue and progressive paresthesias spreading from his left foot to his bilateral lower extremities and then upper extremities and face.
On presentation, vital signs were stable and the physical exam was notable for bilateral lower extremity weakness, 1+ lower extremity deep tendon reflexes, and equal sensation to light touch in bilateral L2-S1 dermatomes. The patient denied infectious symptoms or sick contacts.
CT head imaging showed no acute pathology. CT and MRI total spine imaging was notable for mild cervical spine degenerative changes without focal lesions, significant spinal canal stenosis, or significant neuroforaminal stenosis. CSF analysis demonstrated albuminocytologic dissociation and a negative infectious panel. The patient was then treated with a 5-day course of intravenous immune globulin for a confirmed diagnosis of GBS and was discharged to an acute rehab hospital.

Setting: Acute medical and acute rehabilitation hospitals.

Assessment/Results: Patient received physical and occupational therapy at the acute rehabilitation hospital and saw significant improvements in his gait, bed mobility, and transfers. He was discharged with home therapy and a rolling walker for ambulation.

Discussion (relevance): Although multiple studies have explored post-surgical GBS, there is a paucity of documented cases of GBS acutely after TKA. Thus, this report adds to the knowledge gap. This case is also relevant to physiatrists caring for patients who have undergone a TKA when evaluating new neurological symptoms.

Conclusions: Although rare, GBS should be considered as a possible complication of joint arthroplasty and remain within the diagnostic differential when postoperative patients develop new neurological symptoms.