[Femoral nerve palsy due to excessive granuloma in aseptic cup loosening in cementless total hip arthroplasty].
OBJECTIVE
Femoral nerve palsy after total hip arthroplasty can result from several causes. Delayed neuropathies of the femoral nerve because of excessive granuloma in loosened implants are a rare condition.


METHODS
We report the case of delayed neuropathy of the femoral nerve after cementless total hip arthroplasty because of aseptic loosening of the cup. Electrophysiologic evaluation revealed a severe lesion of the femoral nerve with sensomotoric deficits. An abdominopelvic computed tomography (CT) scan revealed an excessive granuloma with a large intrapelvic portion. After revision of the loosened acetabular component and the femoral nerve and removal of the granuloma the neurologic symptoms improved.


CONCLUSIONS
Regular (1-2 years) clinical and radiological follow-ups are requested after total hip arthroplasty to prevent excessive loosening of implants, excessive granuloma and severe sequelae like nerve damage.
Orthopädische Klinik Rummelsberg, Schwarzenbruck.
A
A
Schuh
S
S
Werber
G
G
Zeiler
B
B
Craiovan
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D004594:Electrophysiology; D005260:Female; D020428:Femoral Neuropathy / Q000209:etiology*; D005500:Follow-Up Studies; D015745:Granuloma, Foreign-Body / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D011475:Prosthesis Failure; D013997:Time Factors; D014057:Tomography, X-Ray Computed