Surgical treatment of obturator nerve palsy resulting from extrapelvic extrusion of cement during total hip arthroplasty

Pećina, Marko; Lucijanić, Ivica; Rosić, Davorka

doi:10.1054/arth.2001.22395

Cited by 10 publications

(3 citation statements)

References 10 publications

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“…It is of great importance to take intraoperative x-rays to avoid some cement spilling for example through transverse acetabular ligament. 8,12 In addition, after reaming of the acetabulum for implantation of the acetabular cup, it is important to directly visualize the bony structure of the acetabulum and consider bone grafting of the acetabulum. 13 In any patient with documented extrusion of cement, we recommend clinical evaluation, neurological exam with some imaging (i.e., CT-Scan).…”

Section: Discussionmentioning

confidence: 99%

Femoral and obturator nerves palsy caused by pelvic cement extrusion after hip arthroplasty.

Zwolak

Eysel²,

Michael³

2011

Orthop Rev

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Cement extrusion into the pelvis with subsequent palsy of the obturator and femoral nerves is a rare entity after hip replacement surgery. Cemented fixation of the acetabular cup has been considered as a safe and reliable standard procedure with very good long term results. We present a case of fifty year old female patient after hip arthroplasty procedure which suffered an obturator and femoral nerve palsy caused by extrusion of bone cement into the pelvis. Postoperative X-rays and CT-scan of the pelvis demonstrated a huge mass consisted of bone cement in close proximity of femoral and obturator nerves. The surgery charts reported shallow and weak bony substance in postero-superior aspect of the acetabulum. This weak bony acetabular substance may have caused extrusion of bone cement during press-fitting of the polyethylene cup into the acetabulum, and the following damage of the both nerves produced by polymerization of bone cement. The bone cement fragment has been surgically removed 3 weeks after arthroplasty. The female patient underwent intensive postoperative physical therapy and electro stimulation which resulted in full recovery of the patient to daily routine and almost normal electromyography results.

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Section: Discussionmentioning

confidence: 99%

Femoral and obturator nerves palsy caused by pelvic cement extrusion after hip arthroplasty.

Zwolak

Eysel²,

Michael³

2011

Orthop Rev

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“…33 When obturator neuropathy is observed secondary to cement extrusion, surgical exploration and removal of the cement may provide symptom relief. 29,34 Lateral Femoral Cutaneous Nerve Palsy…”

Section: Obturator Nerve Palsymentioning

confidence: 99%

Nerve Palsy following Total Hip Arthroplasty: A Review of the Current Literature

Salandra

Deliso

Tang

et al. 2022

The Journal of Hip Surgery

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The incidence of postoperative nerve palsy following total hip arthroplasty (THA) is reported to be 1 to 2%. The most common injury is to the sciatic nerve, but other nerve palsies including the femoral, obturator, and pudendal nerves, have been implicated. There is also an increased risk of nerve palsy following THA in female patients, those who undergo revision procedures, and those with a previous history of developmental hip dysplasia. The prognosis for recovery for each nerve palsy is directly correlated to the extent of nerve damage. Prevention is always the best form of treatment for these conditions, and one method by which this may be accomplished is through electromyography and other variations of intraoperative observation.

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“…Each of these approaches was modified by several authors and has specific advantages and disadvantages, concerning component positioning, hip motion, abductor function, heterotopic ossification and the dislocation rate (3-4-5-6-7). Concerning possible nerve lesions, most of the reported studies are related to the sciatic, femoral and obturator nerves (8-9-10-11-12-13-14-15-16). The lesion of the superior gluteal nerve with a consecutive insufficiency of the tensor fasciae latae muscle or direct surgical trauma of the gluteal muscles represents other problems (17).…”

Section: Introductionmentioning

confidence: 99%

Lesion of Gluteal Nerves and Muscles in Total Hip Arthroplasty through 3 Surgical Approaches. An Electromyographically Controlled Study

et al. 2015

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Surgical treatment of obturator nerve palsy resulting from extrapelvic extrusion of cement during total hip arthroplasty

Cited by 10 publications

References 10 publications

Femoral and obturator nerves palsy caused by pelvic cement extrusion after hip arthroplasty.

Femoral and obturator nerves palsy caused by pelvic cement extrusion after hip arthroplasty.

Nerve Palsy following Total Hip Arthroplasty: A Review of the Current Literature

Lesion of Gluteal Nerves and Muscles in Total Hip Arthroplasty through 3 Surgical Approaches. An Electromyographically Controlled Study

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