Femoral Nerve Palsy due to Noninfectious Iliopsoas Bursitis and Hematoma after Total Hip Arthroplasty: A Case Report

Abstract

Femoral nerve palsy after total hip arthroplasty is an uncommon complication. We present a case report of delayed-onset femoral nerve palsy associated with iliopsoas hematoma and bursitis 10 years after primary total hip arthroplasty in a 57-year-old male patient with avascular necrosis of the femoral head. The patient visited our clinic due to swelling of the inguinal area with sudden-onset knee extension weakness. Radiologic examination at admission revealed suspicion of bursitis and hematoma on iliopsoas muscle. After evacuation of the hematoma and bursitis debridement, the patient's clinical symptoms improved dramatically. This is a rare report of femoral nerve palsy due to noninfectious iliopsoas bursitis and hematoma after total hip arthroplasty.

A Case of Iliopsoas Bursitis With Compressive Femoral Nerve Palsy Treated With Iliopsoas Tendon Release

“…Iliopsoas bursal distention may also be palpable as an inguinal or lower abdominal mass [ 6 ]. The anatomical location and proximity of the iliopsoas bursa to the femoral neurovascular bundle (femoral nerve, femoral artery, and femoral vein) is well documented in the literature [ 11 , [15] , [16] , [17] ]. It is because of this anatomic proximity that neurovascular compromise can occur by mass effect with bursal distention [ 3 ].…”