Common peroneal nerve palsy after primary total hip arthroplasty

Georgeanu, Vlad Alexandru; Russu, Octav; Obadă, Bogdan; Iliescu, Mădălina-Gabriela; Popescu, Marius; Iliescu, Dan; Predescu, Vlad

doi:10.1007/s00264-022-05477-z

Cited by 15 publications

(3 citation statements)

References 31 publications

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“…2.2%-42.5% of patients were reported to have at least some symptoms of superior gluteal nerve lesion after direct lateral approach which results in temporary abductor weakness and in rare cases this problem can be persistent. In our series there is no iatrogenic nerve injury registered 14,15 .…”

Section: Discusionmentioning

confidence: 44%

Clinical outcomes of modified direct lateral approach of Hardinge for total hip arthroplasty

OBADA,

ILIESCU,

POPESCU

et al. 2023

Acta Orthop Belg

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The aim of the study was to evaluate a modified direct lateral approach for total hip arthroplasty in terms of clinical and functional outcomes, rate of complications and hospitalization. We retrospectively reviewed the data of 526 patients with THA operated in our department between January 2017 and December 2021. Clinical examination, functional outcome and radiographic evaluation were performed during follow-up. Patients were evaluated at the following time points: preoperatively and postoperatively at 3 days, 6 weeks, 12 weeks and 1 year and we registered surgery related data, complications, Visual Analogue Scale pain score, Harris Hip Score, the Western Ontario McMaster Osteoarthritis Index. Low intraoperative blood loss, short operation time, short hospitalization, early mobilization of the patient and good range of motion imposed the modified direct lateral approach as a valuable procedure for the patients with THA. VAS score evaluated at 3 days and 6 weeks indicated a very good overall postoperative experience. The HHS and Womac scores were evaluated at 6 weeks, 12 weeks and 1 year and showed excellent results. Trendelenburg gait and abductor weakness, traditionally related with direct lateral approach, were not significant statistically and complete reversible. We registered a very low complication rates with good functional outcome. The modified direct lateral approach can lead to superior outcomes, improved quality of life, with reduced intra and postoperative complications rate.

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Section: Discusionmentioning

confidence: 44%

Clinical outcomes of modified direct lateral approach of Hardinge for total hip arthroplasty

OBADA,

ILIESCU,

POPESCU

et al. 2023

Acta Orthop Belg

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“…Using 3D-printed models may be of particular use when important spine deformities are associated [30][31][32][33][34]. Orthopedic surgeons should also consider that nerve injury can occur during treatment and is dependent on the surgical approach, patient risk factors, and initial severity of neurological deficit [35,36].…”

Section: Management Strategiesmentioning

confidence: 99%

Beyond the Bony Fragment: A Review of Limbus Vertebra

Nișcoveanu,

Refi,

Obada

et al. 2024

Cureus

Self Cite

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Vertebral limbus is a condition characterized by the intraspongious herniation of a portion of the nucleus pulposus. It is often asymptomatic, but it can sometimes cause nonspecific symptoms such as local pain and muscle spasm, or, in rare cases, radiculopathies, which is why it can be confused with vertebral fractures, spondyloarthropathies, infectious or tumoral processes. Early recognition of this pathology is preferable for a correct diagnosis and adequate treatment, the latter ranging from conservative approaches (such as personalized exercise programs and physical therapy) to surgical interventions reserved for severe cases with nerve compression.

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“…7 Rarely, the palsy may develop as a consequence of CPN injury at the knee level, and there are only a few papers concerning their surgical management, 8,9 with a recently reported incidence of 0.48%. 10 The open reduction and internal fixation (ORIF) of the acetabular fracture is performed less often than the THA, thus the associated CPN injuries at the knee level are extremely rare. 11,12 To the best of our knowledge, a thoroughly analyzed case of surgical treatment of such injury is not reported in the English medical literature.…”

Section: Introductionmentioning

confidence: 99%

Peroneal Nerve Injury due to Hip Surgery Located at the Knee Level: A Case Report

Mićić

Rasulić

2023

Int J Med Stud

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Background: A common peroneal nerve (CPN) injury located at the knee level, occurring as a consequence of hip surgery is described in the literature. However, there are only a few papers focusing on their surgical management, while there are no thoroughly analyzed cases following open reduction and internal fixation (ORIF) of the acetabular fracture. This paper aimed to describe such a case and discuss current trends in the surgical management of these patients. Case: A 32-year-old woman was admitted to our department due to left-sided CPN palsy. The patient was injured in a traffic accident eight months earlier, followed by left hip dislocation and acetabular fracture. Following the acetabular fracture ORIF, a CPN palsy developed. The electromyoneurography (EMNG) and ultrasound (US) indicated a nerve lesion at the knee level. The surgical treatment included external neurolysis, decompression, and complete nerve deliberation, with the preservation of all nerve branches. The patient reported immediate relief and completely recovered 8 months following the surgery (Medical Research Council (MRC) grade = 5, Visual Analogous Scale (VAS) = 0). Conclusion: The cause of CPN palsy following hip surgery may not always be located in the hip region. A detailed anamnesis, physical examination, and diagnostic evaluation are necessary for the proper surgical management of these patients. In addition to the EMNG, the US should be essential in preoperative planning and choosing the most effective surgical strategy.

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Common peroneal nerve palsy after primary total hip arthroplasty

Cited by 15 publications

References 31 publications

Clinical outcomes of modified direct lateral approach of Hardinge for total hip arthroplasty

Clinical outcomes of modified direct lateral approach of Hardinge for total hip arthroplasty

Beyond the Bony Fragment: A Review of Limbus Vertebra

Peroneal Nerve Injury due to Hip Surgery Located at the Knee Level: A Case Report

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