Sciatic nerve palsy after total hip replacement

Sciatic nerve palsies are rare but potentially devastating complications, accounting for more than 90% of neurologic injuries following total hip replacement. A systematic literature screening was carried out searching papers evaluating an exclusive population of postarthroplasty sciatic nerve palsies to ascertain (1) the influence of limb lengthening itself on sciatic nerve palsy, (2) the most important risk factors, (3) the long-term prognosis, and (4) the outcomes of different treatments. Fourteen manuscripts were finally included. The wide prevalence of retrospective case series decreased the global methodological quality of the retrieved papers. A hazardous lengthening threshold cannot be surely identified. Developmental dysplasia of the hip and previous hip surgeries are the most frequently recognized risk factors. Rate of full nerve function restoration approximates two-thirds of the cases, independently of the extent of initial neural damage. Poor evidences are available about the best treatment strategy. Well-structured multicentric prospective comparative studies are needed to substantiate or contrast the finding of this review. Anyway, since the onset of palsies is probably due to a combination of individual factors, risk of nerve damage and potential for nerve recovery should be evaluated on an individual basis.

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Exploration and neurolysis for the treatment of neuropathic pain in patients with a sciatic nerve palsy after total hip replacement

The Bone & Joint Journal ◽

10.1302/0301-620x.95b1.29740 ◽

2013 ◽

Vol 95-B (1) ◽

pp. 20-22 ◽

Cited By ~ 13

Author(s):

S. Kyriacou ◽

P. S. Pastides ◽

V. K. Singh ◽

L. Jeyaseelan ◽

M. Sinisi ◽

...

Keyword(s):

Neuropathic Pain ◽

Sciatic Nerve ◽

Total Hip Replacement ◽

Hip Replacement ◽

Nerve Palsy ◽

Sciatic Nerve Palsy ◽

Total Hip

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Management of a full-thickness burn to the foot following sciatic nerve palsy secondary to primary total hip replacement

BMJ Case Reports ◽

10.1136/bcr-2012-008157 ◽

2013 ◽

Vol 2013 (apr16 1) ◽

pp. bcr2012008157-bcr2012008157

Author(s):

S. Jabir ◽

Q. Frew ◽

N. El-Muttardi ◽

P. Dziewulski

Keyword(s):

Sciatic Nerve ◽

Total Hip Replacement ◽

Hip Replacement ◽

Nerve Palsy ◽

Full Thickness ◽

Sciatic Nerve Palsy ◽

Total Hip

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Sciatic nerve palsy secondary to postoperative haematoma in primary total hip replacement

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.87b11.16736 ◽

2005 ◽

Vol 87-B (11) ◽

pp. 1465-1467 ◽

Cited By ~ 54

Author(s):

A. J. Butt ◽

T. McCarthy ◽

I. P. Kelly ◽

T. Glynn ◽

G. McCoy

Keyword(s):

Sciatic Nerve ◽

Total Hip Replacement ◽

Hip Replacement ◽

Nerve Palsy ◽

Sciatic Nerve Palsy ◽

Total Hip ◽

Postoperative Haematoma

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Sciatic Nerve Palsy following Total Hip Replacement via Direct Anterior Approach after Recommencement of Warfarin for Prophylaxis in Atrial Fibrillation

Case Reports in Orthopedics ◽

10.1155/2014/810481 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Vipin Asopa ◽

Shafic Al-Nammari ◽

Tony Spriggins ◽

Tony Menz ◽

Adrian Bauze

Keyword(s):

Atrial Fibrillation ◽

Sciatic Nerve ◽

Total Hip Replacement ◽

Hip Replacement ◽

Anterior Approach ◽

Nerve Palsy ◽

Early Recognition ◽

Delayed Diagnosis ◽

Sciatic Nerve Palsy ◽

Total Hip

The occurrence of sciatic nerve palsy following posterior and anterolateral approaches to the hip has been well documented and is about 1-2%. To our knowledge, however, there are no reports of sciatic nerve palsy occurring secondary to the anterior approach to the hip for arthroplasty. We describe a case of sciatic nerve palsy secondary to haematoma formation following total hip replacement through the anterior approach. The recommencement of warfarin for prophylaxis against atrial fibrillation is thought to have been a contributing factor. Full recovery is rare following delayed diagnosis and early recognition of the signs of pain, parasthesia, and gradual loss of dorsiflexion and prompt drainage may reverse the condition. We advise caution with restarting warfarin following total hip arthroplasty.

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