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Update on nerve palsy associated with total hip replacement
T P Schmalzried1, S Noordin, H C Amstutz
1Joint Replacement Institute, Orthopaedic Hospital, Los Angeles, CA 90007, USA.
Clinical Orthopaedics and Related Research
|December 31, 1997
Summary
Nerve palsy after total hip replacement affects about 1% of patients, often involving the sciatic nerve. Most patients experience some recovery, but 15% have significant long-term deficits.
Area of Science:
- Orthopedic Surgery
- Neurology
Background:
- Nerve palsy is a recognized complication of total hip replacement (THR).
- It occurs in approximately 1% of patients, with the sciatic nerve most commonly affected (nearly 80%).
- Risk factors include female sex, developmental dysplasia, and revision surgery.
Purpose of the Study:
- To review the incidence, risk factors, and outcomes of nerve palsy following total hip replacement.
- To explore potential causes and prognostic indicators for neurologic recovery.
Main Methods:
- Review of existing literature on nerve palsy after total hip replacement.
- Analysis of reported prevalence, affected nerves, risk factors, and patient outcomes.
Main Results:
- Sciatic nerve involvement is most common (80%).
- Risk is higher in females, those with developmental dysplasia, and revision cases.
- Complete recovery occurs in 41%, mild deficit in 44%, and poor outcome in 15%.
- Early motor function post-op or within 2 weeks predicts better recovery.
Conclusions:
- Nerve palsy is an uncommon but significant complication of THR.
- Prognosis depends on the degree of nerve damage and early signs of recovery.
- Unrecognized nerve compression may contribute to palsy development.