Foot drop following primary total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Neurology
• Biomedical Engineering

Background:

• Foot drop is a significant complication after total hip arthroplasty (THA), often resulting from sciatic nerve injury.
• Understanding its incidence, risk factors, and outcomes is crucial for patient management and surgical technique refinement.

Purpose of the Study:

• To determine the incidence, identify risk factors, and evaluate the outcomes of foot drop following primary total hip arthroplasty (THA).

Main Methods:

• A retrospective analysis of 10,624 primary THAs performed via a posterior approach between 1993 and 2017.
• Data collection focused on patient demographics, surgical details, and postoperative neurological status.

Main Results:

• The overall incidence of foot drop was 0.44%, with a statistically significant decrease in incidence over the study period (0.6% to 0.3%, p=0.033).
• Significant risk factors identified were preoperative protrusio acetabulae (p < 0.001), female sex (p < 0.001), and junior grade of surgeon (p = 0.009). Dysplasia was not a significant risk factor.
• One year postoperatively, 53.2% of patients experienced complete recovery, 25.5% had sensory deficits with normal power, and 21.3% had residual sensory-motor deficits.

Conclusions:

• Protrusio acetabulae, female sex, and less experienced surgeons are significant risk factors for developing foot drop after primary THA.
• The incidence of foot drop has decreased over time, suggesting improvements in surgical practices or patient selection.
• Outcomes for foot drop following THA are variable, with a majority showing some degree of recovery within one year.