Postoperative Sciatic and Femoral Nerve Palsy With Reference to Leg Lengthening and Medializatiod Lateralization of the Hip Joint Following Total Hip Arthroplasty

Nercessian, Ohannes A.; Piccoluga, Francisco; Eftekhar, Nas S.

doi:10.1097/00003086-199407000-00025

Cited by 80 publications

(43 citation statements)

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“…We recommend performing anatomic reconstructions at the level of the true acetabulum whenever possible to ensure optimal hip mechanics. However, the sciatic nerve is at risk in hip reconstructions, especially with high dislocations [11,13,18,31,37]. In this study we had one sciatic nerve palsy in a hip graded Crowe III/Eftekhar B preoperatively and reconstructed at the anatomical center of rotation.…”

Section: Discussionmentioning

confidence: 97%

Favorable Survival of Acetabular Reconstruction With Bone Impaction Grafting in Dysplastic Hips

Somford

Bolder

Gardeniers

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 97%

Favorable Survival of Acetabular Reconstruction With Bone Impaction Grafting in Dysplastic Hips

Somford

Bolder

Gardeniers

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…LLD after THA has been associated with complications, including sciatic, femoral, and peroneal nerve palsies [32,34,46,50]; low back pain [1,9,13,14]; abnormal gait [17,26]; and dislocation [56].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Radiographic Assessment of Limb-length Discrepancy in Total Hip Arthroplasty

Meermans

Malik

Witt

et al. 2011

Clinical Orthopaedics &Amp; Related Research

153

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Background Pelvic radiographs are helpful in assessing limb-length discrepancy (LLD) before and after THA but are subject to variation. Different methods are used to determine LLDs. As a pelvic reference, both ischial tuberosities and the teardrops are used, and as a femoral reference, the lesser trochanter and center of the femoral head are used. Questions/purposes We validated the different methods for preoperative radiographic measurement of LLDs and evaluated their reliability. Patients and Methods LLDs were measured on full-leg radiographs for 52 patients (29 men, 23 women) with osteoarthritis (OA) of the hip and compared with different methods for measuring LLDs on AP radiographs of the pelvis. Results The true LLD varied from À8.0 to 9.1 mm. When the biischial line was used as a pelvic reference, the LLD measured on AP pelvis radiographs was different from the true LLD. No difference was found when the interteardrop line was used as a pelvic reference. There was substantial interobserver agreement when the lesser trochanter was used as a femoral reference (kappa = 0.66-0.70) and excellent interobserver and intraobserver agreement for all other measurements (kappa = 0.84-0.93). Conclusions Our data show use of the biischial line as a pelvic reference should be discouraged and the interteardrop line is a better alternative. The center of the femoral head is a more reliable femoral landmark compared with the lesser trochanter. Level of Evidence Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

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“…[1][2][3][4][5][6] Several studies have confirmed that an important factor is limb lengthening, 3,[5][6][7][8] especially in patients with old developmental dysplasia of the hip (DDH). 1,5 We investigated this relationship in 508 consecutive primary THRs for old DDH.…”

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confidence: 99%

Nerve palsy after leg lengthening in total replacement arthroplasty for developmental dysplasia of the hip

Eggli

Hankemayer

Müller³

1999

The Journal of Bone and Joint Surgery. British volume

109

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We reviewed 508 consecutive total hip replacements in 370 patients with old developmental dysplasia of the hip, to relate the amount of leg lengthening to the incidence of nerve palsies after operation. There were eight nerve palsies (two femoral, six sciatic), two complete and six incomplete.We found no statistical correlation between the amount of lengthening and the incidence of nerve damage (p = 0.47), but in seven of the eight hips, the surgeon had rated the intervention as difficult because of previous surgery, severe deformity, a defect of the acetabular roof, or considerable flexion deformity. The correlation between difficulty and nerve palsy was significant (p = 0.041). We conclude that nerve injury is most commonly caused by direct or indirect mechanical trauma and not by limb lengthening on its own.

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Postoperative Sciatic and Femoral Nerve Palsy With Reference to Leg Lengthening and Medializatiod Lateralization of the Hip Joint Following Total Hip Arthroplasty

Cited by 80 publications

References 0 publications

Favorable Survival of Acetabular Reconstruction With Bone Impaction Grafting in Dysplastic Hips

Favorable Survival of Acetabular Reconstruction With Bone Impaction Grafting in Dysplastic Hips

Preoperative Radiographic Assessment of Limb-length Discrepancy in Total Hip Arthroplasty

Nerve palsy after leg lengthening in total replacement arthroplasty for developmental dysplasia of the hip

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