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Nerve injuries in total hip arthroplasty.
1Huebner Medical Center, San Antonio, Tex., USA.
The Journal of the American Academy of Orthopaedic Surgeons
|April 28, 1999
Summary
Nerve injuries affect 1-2% of total hip arthroplasty patients, particularly those with hip dysplasia or revision surgery. Prevention and prompt pain management are key, while electrodiagnostic studies need further research for intraoperative use.
Area of Science:
- Orthopedic Surgery
- Neurology
- Medical Research
Background:
- Nerve injury is a known complication of total hip arthroplasty (THA), occurring in 1-2% of patients.
- Higher incidence rates are observed in patients undergoing acetabular reconstruction for dysplasia and those requiring revision THA.
- Commonly injured nerves include the peroneal division of the sciatic nerve, superior gluteal, obturator, and femoral nerves.
Purpose of the Study:
- To review the incidence, classification, and management of nerve injuries associated with total hip arthroplasty.
- To highlight the importance of preventative strategies and current treatment options for nerve damage.
- To evaluate the potential role of electrodiagnostic studies in managing these injuries.
Main Methods:
- Literature review of nerve injury in total hip arthroplasty.
- Classification of nerve injuries (neurapraxia, axonotmesis, neurotmesis).
- Discussion of prognostic factors and treatment modalities.
Main Results:
- Nerve injury rates range from 1% to 2% in THA patients.
- Peroneal division of the sciatic nerve is the most frequently injured.
- Complete motor/sensory deficits and causalgic pain indicate a poorer prognosis.
Conclusions:
- Prevention of nerve injury during THA is paramount.
- Ankle-foot orthoses and pain syndrome management are beneficial treatments.
- Further rigorous studies are needed to establish the intraoperative utility of electrodiagnostic studies.