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Nerve Injuries After Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.
Abdullah Alturki1,2,3, Turki Almugren1,2, Ali Alhandi1,2
1Department of Orthopedic Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
Orthopedic Reviews
|April 27, 2026
Summary
Nerve injuries after total hip arthroplasty (THA) are uncommon but can lead to significant disability. Comorbidity burden is a key risk factor, highlighting the need for careful surgical technique and patient risk stratification.
Area of Science:
- Orthopedics
- Neurology
- Surgical Complications
Background:
- Nerve injury is a rare but serious complication following total hip arthroplasty (THA).
- Uncertainty persists regarding the true incidence, risk factors, and prognosis of nerve injuries post-THA.
- Outcomes range from complete recovery to long-term neurological deficits.
Purpose of the Study:
- To systematically review and meta-analyze the incidence, risk factors, and outcomes of nerve injuries after THA.
- To identify patterns of nerve injury and associated clinical and surgical factors.
- To synthesize current evidence on recovery and long-term prognosis.
Main Methods:
- Systematic review and meta-analysis of 17 diverse studies.
- Inclusion of large database analyses and focused case series.
- Random-effects modeling for pooled proportions and meta-regression for predictor assessment.
Main Results:
- Pooled incidence of nerve injury post-THA was 0.36%.
- The peroneal nerve division was most vulnerable; common injuries involved sciatic, peroneal, and femoral nerves.
- Complete recovery was observed in 48.6%, while 50.5% experienced residual deficits; 39.8% had permanent impairment.
- Comorbidity burden was the only significant predictor identified via meta-regression.
Conclusions:
- Nerve injuries following THA represent a significant clinical challenge with variable outcomes.
- Early detection, meticulous surgical technique, and risk stratification in patients with comorbidities are crucial.
- Improved prevention and management strategies are needed to mitigate long-term neurological deficits.
