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[Nerve injuries after computer-assisted hip replacement: case series with 29 patients]
1Sektion Neurologie mit Klinischer Neurophysiologie, St. Marienkrankenhaus, Akad. Lehrkrankenhaus der Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt/Main. zipper@em-uni.frankfurt.de
Insights
Computer-assisted hip replacement (CAHR) does not present a specific nerve injury risk. Transient nerve damage may occur in the first year post-surgery, but permanent disability is not evident.
Area of Science:
- Orthopedic Surgery
- Neurology
- Medical Technology
Context:
- Computer-assisted hip replacement (CAHR), utilizing systems like ROBODOC, is increasingly used in Germany.
- Growing patient and physician concerns exist regarding persistent pain and walking difficulties post-CAHR.
- The potential for nerve injury following CAHR requires investigation due to inconsistent neurological data.
Purpose:
- To determine the specific risk of nerve injuries associated with computer-assisted hip replacement (CAHR).
- To evaluate neurological and neurophysiological outcomes in patients who underwent CAHR.
Summary:
- A case series of 29 patients (30 operated joints) after CAHR with ROBODOC underwent systematic neurological and neurophysiological examination.
- Functionally relevant nerve injuries were identified in 3.1% of operated sites, leading to temporary disability within the first year.
- No permanent disability due to nerve injury was observed.
Impact:
- Findings suggest CAHR does not carry a specific risk of nerve injury.
- The incidence of transient nerve damage in the first year post-CAHR may be slightly higher than with conventional hip replacement.
- This study provides crucial neurophysiological data to address patient and physician concerns about nerve injury after CAHR.
Aim:
In Germany computer-assisted hip replacement (CAHR), e. g., ROBODOC, has been carried out in several thousand cases. After a period of enthusiasm, the technique now faces growing resistance from both patients and physicians. After CAHR many patients complain about persistent pain and problems with walking. Due to these problems, patients very often ask whether they have a nerve injury. In general, it is important to know whether or not there is a specific risk of nerve injuries with CAHR. At present neurological data are inconsistent, and neurophysiological studies have not yet been reported.
Methods:
We have analysed a case series of 29 patients after CAHR with ROBODOC in 30 operated joints. All patients underwent a systematic neurological and neurophysiological examination.
Results:
In 3 out of 30 operated sites functionally relevant nerve injuries were found, which led to disability in the first year after surgery. Permanent disability due to nerve injury was not found.
Conclusion:
There is no evidence of a specific risk of nerve injury after CAHR. The incidence of partial and transient nerve damage in the first year after operation might be higher than in classical hip replacement (3.1 %).
