Nerve palsy after hip replacement surgery

Total hip replacement (THR) surgery has become so common that we tend to think of it as "routine".  For one percent of the patients undergoing first-time surgery, and almost three percent of patients requiring a revision, however, the outcome of this surgery is anything but "routine".  These patients, statistically more likely to be women, suffer extremely painful and debilitating injury to a nerve--usually the sciatic nerve.  If the patient also suffered from hip dysplasia (also far more common among women, congentially), the risk of a permanently damaged nerve is even higher at five percent.

Dr. Thomas Schmalzried, an orthopaedic surgeon from Los Angeles reported these statistics at an Orthopaedic Conference in Hawaii, after he and his partners reviewed more than 34,000 surgeries.  He attributed this complication primarily to variations in anatomy, according to the Orthopedics today Super Site.  In seventy-nine percent of cases, the nerve injured is the sciatic nerve.  The peroneal nerve, which branches near the hip joint is the next most likely to be injured.  He reported that EMG findings documented some degree of nerve injury after total hip replacement in 70% of the involved extremities, following THR.   Schmalzried reported that nerve injury was more common when surgeons utilized an anterior approach ( through an incision on the "front" of the body) and suggested that placement of anterior acetabular retractors may be the culprit.