title: Exploration and neurolysis for the treatment of neuropathic pain in patients with a sciatic nerve palsy after total hip replacement.
abstract: The purpose of this study was to establish whether exploration and neurolysis is an effective method of treating neuropathic pain in patients with a sciatic nerve palsy after total hip replacement (THR). A total of 56 patients who had undergone this surgery at our hospital between September 1999 and September 2010 were retrospectively identified. There were 42 women and 14 men with a mean age at exploration of 61.2 years (28 to 80). The sciatic nerve palsy had been sustained by 46 of the patients during a primary THR, five during a revision THR and five patients during hip resurfacing. The mean pre-operative visual analogue scale (VAS) pain score was 7.59 (2 to 10), the mean post-operative VAS was 3.77 (0 to 10), with a resulting mean improvement of 3.82 (0 to 10). The pre- and post-neurolysis VAS scores were significantly different (p < 0.001). Based on the findings of our study, we recommend this form of surgery over conservative management in patients with neuropathic pain associated with a sciatic nerve palsy after THR.
authors: Royal National Orthopaedic Hospital, Peripheral Nerve Injury Unit, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.
authors: S
authors: S
authors: Kyriacou
authors: P S
authors: PS
authors: Pastides
authors: V K
authors: VK
authors: Singh
authors: L
authors: L
authors: Jeyaseelan
authors: M
authors: M
authors: Sinisi
authors: M
authors: M
authors: Fox
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D003714:Denervation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012584:Sciatic Nerve / Q000601:surgery*; D020426:Sciatic Neuropathy / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome