RESEARCH ARTICLE


Nerve Palsy after Total Hip Arthroplasty without Subtrochanteric Femoral Shortening Osteotomy for a Completely Dislocated Hip Joint



Motoki Sonohata*, Masaru Kitajima, Shunsuke Kawano, Masaaki Mawatari
Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Saga, Japan


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© Sonohata et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Japan; Tel: +81-952-34-2343; Fax: +81-952-34-2059; E-mails: epc9719@yahoo.co.jp, sonohata@cc.saga-u.ac.jp


Abstract

Background:

Neurological injuries are a rare but devastating complication after total hip arthroplasty (THA). The purpose of this study was to retrospectively determine the frequency of nerve palsy after THA without subtrochanteric femoral shortening osteotomy in patients with a completely dislocated hip joint without pseudo-articulation between the femoral head and iliac bone.

Methods:

Between October 1999 and September 2001, nine primary THAs were performed for patients with a completely dislocated hip joint. The limb lengths, neurological abnormalities, and the extent of their neurological recovery were evaluated. Three THAs were combined with subtrochanteric femoral shortening osteotomy, and six THAs were combined without subtrochanteric femoral shortening osteotomy.

Results:

The mean length of the operation was 4.8 cm (range, 3.0-6.5 cm). Sciatic nerve palsy developed in four of the nine patients after THA. None of the cases with sciatic nerve palsy were combined with subtrochanteric femoral shortening osteotomy. Three of four patients did not completely recover from sciatic nerve palsy.

Conclusions:

THA for patients with a completely dislocated hip was associated with a high risk of nerve palsy due to excessive limb lengthening; the potential for recovery from nerve palsy was observed to be poor. Subtrochanteric femoral shortening osteotomy should be used in combination with THA in patients with a completely dislocated hip.

Keywords: Nerve Palsy, Total Hip Arthroplasty, Completely Dislocated Hip Joint, Subtrochanteric Osteotomy, Developmental Dysplasia of the Hip.