title: Neurolysis for the treatment of sciatic nerve palsy associated with total hip arthroplasty.
abstract: Sciatic nerve palsy following total hip arthroplasty (THA) is a relatively rare yet potentially devastating complication. The purpose of this case series was to report the results of patients with a sciatic nerve palsy who presented between 2000 and 2010, following primary and revision THA and were treated with neurolysis. A retrospective review was made of 12 patients (eight women and four men), with sciatic nerve palsy following THA. The mean age of the patients was 62.7 years (50 to 72; standard deviation 6.9). They underwent interfascicular neurolysis for sciatic nerve palsy, after failing a trial of non-operative treatment for a minimum of six months. Following surgery, a statistically and clinically significant improvement in motor function was seen in all patients. The mean peroneal nerve score function improved from 0.42 (0 to 3) to 3 (1 to 5) (p < 0.001). The mean tibial nerve motor function score improved from 1.75 (1 to 4) to 3.92 (3 to 5) (p = 0.02).The mean improvement in sensory function was a clinically negligible 1 out of 5 in all patients. In total, 11 patients reported improvement in their pain following surgery. We conclude that neurolysis of the sciatic nerve has a favourable prognosis in patients with a sciatic nerve palsy following THA. Our findings suggest that surgery should not be delayed for > 12 months following injury.
authors.affiliation: Tel Aviv University, Tel-Aviv, Israel.
authors.forename: G J
authors.initials: GJ
authors.lastname: Regev
authors.affiliation: Tel Aviv University, Tel-Aviv, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Drexler
authors.affiliation: Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Sever
authors.affiliation: University of Toronto, Toronto, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Dwyer
authors.affiliation: Tel Aviv University, Tel-Aviv, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Khashan
authors.affiliation: Tel Aviv University, Tel-Aviv, Israel.
authors.forename: Z
authors.initials: Z
authors.lastname: Lidar
authors.affiliation: Tel Aviv University, Tel-Aviv, Israel.
authors.forename: K
authors.initials: K
authors.lastname: Salame
authors.affiliation: Tel Aviv University, Tel-Aviv, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Rochkind
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D011183:Postoperative Complications / Q000628:therapy*; D012086:Reoperation; D012189:Retrospective Studies; D020426:Sciatic Neuropathy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013979:Tibial Nerve / Q000502:physiology; D016896:Treatment Outcome
keywords: Neurolysis; sciatic nerve palsy; total hip arthroplasty