title: Neuropathic pain following hip resurfacing due to a transneural suture.
abstract: A 60-year-old man developed severe neuropathic pain and foot-drop in his left leg following resurfacing arthroplasty of the left hip. The pain was refractory to all analgesics for 16 months. At exploration, a PDS suture was found passing through the sciatic nerve at several points over 6 cm and terminating in a large knot. After release of the suture and neurolysis there was dramatic and rapid improvement of the neuropathic pain and of motor function. This case represents the human equivalent of previously described nerve ligation in an animal model of neuropathic pain. It emphasises that when neuropathic pain is present after an operation, the nerve related to the symptoms must be inspected, and that removal of a suture or irritant may lead to relief of pain, even after many months.
authors.affiliation: Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK. marcellamarchese@libero.it
authors.forename: M
authors.initials: M
authors.lastname: Marchese
authors.forename: M
authors.initials: M
authors.lastname: Sinisi
authors.forename: P
authors.initials: P
authors.lastname: Anand
authors.forename: L
authors.initials: L
authors.lastname: Di Mascio
authors.forename: J
authors.initials: J
authors.lastname: Humphrey
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D006615:Hip / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D012584:Sciatic Nerve / Q000293:injuries* / Q000601:surgery; D013537:Sutures / Q000009:adverse effects*; D016896:Treatment Outcome