Contributory Factors and Etiology of Sciatic Nerve Palsy in Total Hip Arthroplasty

Edwards, Bruce N.; Tullós, Hugh S.; Noble, Philip C.

doi:10.1097/00003086-198705000-00019

Cited by 231 publications

(178 citation statements)

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“…Sciatic nerve palsies are possible in extreme elongations (although we have had no such occurrences). Nerve palsy, however, usually develops because the nerve is injured with posterior retractors or after large hematomas [6,9]. We do not advise proximal extension greater than 4 cm because of the possibility for superior gluteal nerve lesion, but this disadvantage is common to all lateral approaches.…”

Section: Discussionmentioning

confidence: 99%

Femoral Shortening During Hip Arthroplasty Through a Modified Lateral Approach

Delimar

Bićanić

Koržinek

2008

Clin Orthop Relat Res

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We describe a modification of the direct lateral approach to the hip that provides excellent femoral and acetabular exposure and an easy way to shorten the proximal femur and equalize leg length. The approach also is useful for lower extremity elongation while preserving muscle continuity and minimizing postoperative complications. The exact amount of shortening can be calculated and planned preoperatively and measured and corrected intraoperatively if necessary. It avoids the necessity for osteotomies of the trochanter and transverse cuts or detachment of abductor muscles.

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Section: Discussionmentioning

confidence: 99%

Femoral Shortening During Hip Arthroplasty Through a Modified Lateral Approach

Delimar

Bićanić

Koržinek

2008

Clin Orthop Relat Res

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“…This nerve is at particular risk with other anterior approaches to the hip, such as pelvic osteotomies and iliac crest bone graft harvesting [9,19,28,32,42,43,67]. Although injury to the LFCN does not represent a major neurologic complication as compared with the potentially catastrophic outcomes of sciatic and femoral nerve palsies [4,20,21,23,31,54,55], its incidence after joint arthroplasty through an anterior approach is not well reported [39,49,57,61].…”

Section: Introductionmentioning

confidence: 99%

Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

Goulding

Beaulé

Kim

et al. 2010

Clinical Orthopaedics &Amp; Related Research

205

145

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Background Although injury to the lateral femoral cutaneous nerve (LFCN) is a known complication of anterior approaches to the hip and pelvis, no study has quantified its' incidence in anterior arthroplasty procedures. Questions/purposes We therefore defined the incidence, functional impact, and natural history of LFCN neuropraxia after an anterior approach for both hip resurfacing (HR) and primary total hip arthroplasty (THA). Methods We followed 132 patients who underwent an anterior hip approach (55 THA; 77 HR). We administered self-reported questionnaires for sensory deficits of LFCN, neuropathic pain score (DN4), visual analog scale, as well as SF-12, UCLA, and WOMAC scores at one year postoperatively. A subset of 60 patients (30 THA; 30 HR) was evaluated at two time intervals. Results One hundred seven patients (81%) reported LFCN neuropraxia with a mean severity score of 2.32/10 and a mean DN4 score of 2.42/10. Hip resurfacing had a higher incidence of neuropraxia as compared with THA: 91% versus 67%, respectively. No functional limitations were reported on SF-12, WOMAC, or UCLA scores. Of the subset of 60 patients followed over an average of 12 months, 53 (88%) reported neuropraxia at the first followup interval with only three (6%) having complete resolution at second followup. Improvement in DN4 scores was observed over time: 3.6 versus 2.5, respectively. Conclusions Although LFCN neuropraxia was a frequent complication after anterior approach THA, it did not lead to functional limitations in our patients. A decrease in symptoms occurred over time but only a small number of patients reported complete resolution. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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“…Sexo feminino -Weber et al (17) , Solheim et al (20) , Johanson et al (23) , Edwards et al (27) , Navarro et al (33) encontraram prevalência muito maior no sexo feminino. Isso provavelmente deve-se ao fato de que as mulheres, quando comparadas com os homens, são menores em altura e têm membros menores associados a menor massa muscular e, portanto, mais suscetíveis à lesão nervosa periférica.…”

Section: Etiologia E Fatores De Riscounclassified

“…Como, na maioria dos casos há necessidade de alongamento do membro inferior, o risco se torna mais elevado ainda. Stern et al (6) 1972 50 2 4,0 Charnley et al (7) 1973 185 2 1,1 Evarts et al (8) 1973 200 6 3,0 Langenskiold et al (9) 1973 116 1 0,9 Wilson et al (10) 1973 108 4 3,7 Lubinus (11) 1973 1.350 28 2,1 Lazansky (12) 1973 501 6 1,2 Buchholz et al (13) 1973 3.948 76 1,9 Eftekhar et al (14) 1973 800 12 1,5 Murray (15) 1973 808 15 1,9 Smith (16) 1973 112 1 0,9 Weber et al (17) 1976 2.012 14 0,7 Moczynski et al (18) 1976 237 3 1,3 Beckenbaugh et al (19) 1978 300 4 1,3 Sarmiento et al (25) 1979 237 7 3,0 Solheim et al (20) 1980 825 6 0,7 Robinson et al (21) 1980 316 2 0,6 Amstutz et al (5) 1982 66 5 7,6 Tillberg (22) 1982 327 3 0,9 Johanson et al (23) 1983 5.667 36 0,6 Ahlgren et al (24) 1984 150 1 0,7 Andrew et al (26) 1985 179 1 0,6 Edwards et al (27) 1987 614 7 1,1 Soballe et al (28) 1987 213 1 0,5 Mok et al (29) 1989 251 4 1,6 Schmalzried et al (30) 1991 3.126 53 1,7 Simmons et al (31) 1991 440 10 2,3 Dhillon et al (32) 1992 380 6 1,6 Nercessian et al (2) 1994 7.133 45 0,63 Nercessian et al (4) 1994 1.287 1 0,08 Navarro et al (33) 1995 1.000 8 0,8 Linclau et al (34) 1995 1.463 7 0,5 Oldenburg et al (35) 1997 2.723 61 2,2 Pekkarinen et al (36) 1999 4.339 27 0,6 Eggli et al (37) 1999 508 8 1,6 Butt et al (38) 2005 355 6 1,7 Farrell et al (39) 2005 27.004 47 0,17 Hurd et al …”

Section: Cirurgia De Revisão -Schmalzried Et Alunclassified