Neurologic injuries after total hip arthroplasty.
Neurologic injuries are a potentially devastating complication of total hip arthroplasty (THA). Review of the literature reveals that these injuries are uncommon. The reported incidence ranges from 0.08% to 7.6%. The incidence in primary THA ranges from 0.09% to 3.7% and in revision THA from 0% to 7.6%. Reported etiologies include intraoperative direct nerve injury, significant leg lengthening, improper retractor placement, cement extravasation, cement-related thermal damage, patient positioning, manipulation, and postoperative hematoma. Risk factors include developmental dysplasia of the hip, the female sex, posttraumatic arthritis, and revision surgery. However, no single risk factor has been consistently reported to be significant, and many patients with no known risk factors incur neurologic injuries.
Department of Orthopaedic Surgery, New York Orthopaedic Hospital, Columbia University Medical Center, New York, NY 10032, USA. gb2144@columbia.edu
Gabriel D
GD
Brown
Eli A
EA
Swanson
Ohannes A
OA
Nercessian
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002081:Buttocks / Q000293:injuries / Q000294:innervation; D005267:Femoral Nerve / Q000293:injuries; D020428:Femoral Neuropathy / Q000453:epidemiology; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D009776:Obturator Nerve / Q000293:injuries; D059348:Peripheral Nerve Injuries; D010543:Peroneal Nerve / Q000293:injuries; D011379:Prognosis; D012086:Reoperation; D012307:Risk Factors; D012584:Sciatic Nerve / Q000033:anatomy & histology