The frequency, prognosis and significance of nerve injuries in total hip arthroplasty.
Although the incidence of post-operative nerve palsy after total hip replacement is rare, it is an important complication for the patient. In a retrospective study the results of 2713 hip arthroplasties were reviewed. Sixty-one cases (2.24%) of post-operative neuropathy were identified. 13 of the sciatic nerve, 33 of the peroneal nerve and 15 of the femoral nerve. The risk is significantly higher in revisions (3.06%), especially when exchanging the acetabular component (8.5%) rather than in primary arthroplasties (2.13%). After an average period of 107 months (11-240) from operation, 41 patients with nerve lesions were questioned about their subjective functional capacity: 17% had recovered completely, 39% had noticed an improvement, and in 44% there was no change; 56.1% complained of weakness and had a complete paralysis. In all cases there was dysfunction of sensibility. Another 17.1% had a sensibility defect without weakness. There was pain in 51.2%, paraesthesia in 34.1% and areas of complete anaesthesia in 19.5%. Altogether 61% of the 41 patients had either gait problems or were dependent on orthotic devices. In summary, only about a third of the patients studied achieved a satisfactory degree of functional recovery.
Oldenburg
M
M
Orthopädische Universitäts- und Poliklinik Essen, Germany.
Müller
R T
RT
D005260:Female; D005267:Femoral Nerve / Q000293:injuries; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D059348:Peripheral Nerve Injuries; D010543:Peroneal Nerve / Q000293:injuries; D012189:Retrospective Studies; D012584:Sciatic Nerve / Q000293:injuries