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Risk Factors for Perioperative Nerve Injury Related to Total Hip Arthroplasty
Rahul H Jayaram1, Wesley Day2, Michael J Gouzoulis1
1Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA.
Arthroplasty Today
|August 14, 2024
Summary
Nerve injury after total hip arthroplasty (THA) is rare (0.35%). Revision surgery, female sex, higher comorbidity index, and older age increase risk. Morbidly obese patients had a decreased risk.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Patient Safety
Background:
- Nerve injury is a rare but serious complication of total hip arthroplasty (THA).
- Previous studies on THA-related nerve injury risk factors were limited by small sample sizes or institutional data.
- This study utilizes a large national database to identify independent risk factors for nerve injury following THA.
Purpose of the Study:
- To identify independent risk factors for nerve injury after total hip arthroplasty (THA).
- To provide data for risk stratification and patient counseling regarding THA procedures.
Main Methods:
- A retrospective analysis of the 2010-2021 PearlDiver M157 database was conducted.
- Adult THA cases with nerve injury within 90 days were identified.
- Multivariate analyses assessed correlations between patient demographics, comorbidities, indication, and surgery type with nerve injury.
Main Results:
- Out of 750,695 THAs, 0.35% resulted in nerve injury.
- Independent predictors of nerve injury included revision surgery (OR: 2.13), female sex (OR: 1.35), higher Elixhauser Comorbidity Index (ECI), and age.
- Morbidly obese patients (BMI ≥35) showed a decreased risk (OR: 0.84).
Conclusions:
- Total hip arthroplasty-related nerve injury is infrequent (0.35%).
- Revision procedures present the highest risk for nerve injury.
- Identified risk factors can aid in patient counseling and risk stratification for THA.
