Neurologic injuries after total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Neurology
• Medical Complications

Background:

• Neurologic injuries represent a significant, though uncommon, complication following total hip arthroplasty (THA).
• The reported incidence of these injuries spans a wide range, from 0.08% to 7.6% across various studies.
• Both primary and revision THA procedures carry a risk, with incidences varying between 0.09%-3.7% and 0%-7.6%, respectively.

Purpose of the Study:

• To review and synthesize the current literature on neurologic injuries associated with total hip arthroplasty.
• To identify and categorize the reported etiologies and potential risk factors for these injuries.
• To provide an overview of the incidence rates in both primary and revision THA procedures.

Main Methods:

• Comprehensive review of existing medical literature pertaining to neurologic complications after THA.
• Analysis of reported cases to identify common causes and contributing factors.
• Compilation and comparison of incidence data from primary versus revision THA.

Main Results:

• The incidence of neurologic injury in THA is generally low, ranging from 0.08% to 7.6%.
• Etiologies are diverse, including direct nerve trauma, leg length discrepancy, surgical technique issues (retractors, cement), and postoperative hematoma.
• Identified risk factors such as hip dysplasia, female sex, arthritis, and revision surgery lack consistent significance, with injuries occurring in patients without known risk factors.

Conclusions:

• Neurologic injuries are an infrequent but serious risk in total hip arthroplasty.
• Multiple intraoperative and postoperative factors can contribute to nerve damage.
• Predicting or preventing these injuries remains challenging due to inconsistent risk factor identification.