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J Arthroplasty. 2017 Apr;32(4):1335-1339. doi: 10.1016/j.arth.2016.10.032. Epub 2016 Nov 2.

Nerve Decompression Surgery After Total Hip Arthroplasty: What Are the Outcomes?

Author information

1
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
2
Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
3
Department of Orthopaedic Surgery, University of Mississippi, Jackson, Mississippi.

Abstract

BACKGROUND:

The purpose of our study was to compare (1) muscle strength; (2) pain; (3) sensation; (4) various outcome measurement scales between post-total hip arthroplasty (THA) patients who had a sciatic nerve injury and did or did not receive decompression surgery for this condition; and (5) to compare these findings with current literature.

METHODS:

Nineteen patients who had nerve injury after THA were reviewed. Patients were stratified into those who had a nerve decompression (n = 12), and those who had not (n = 7). Motor strength was evaluated using the Muscle Strength Testing Scale. Pain was evaluated by using the visual analogue scale. Systematic literature search was performed to compare the findings of this study with others currently published.

RESULTS:

The decompression group had a significant improvement in motor strength and the visual analog scale scores as compared with nonoperative group. Patients in decompression group had a significant larger increase in the mean Harris hip score and University of California Los Angeles score. There was no significant difference in the increase of Short Form-36 physical and mental scores between the 2 groups. Literature review for nonoperative management yielded 5 studies (93 patients), with 33% improvement. There were 7 studies (81 patients) on nerve decompression surgery, with 75% improvement.

CONCLUSION:

This study demonstrates the benefits of nerve decompression surgery in patients who had sciatic nerve injury after THA, as evidenced by results of standardized outcome measurement scales. It is possible to achieve improvements in terms of strength, pain, and clinical outcomes. Comparative studies with larger cohorts are needed to fully assess the best candidates for this procedure.

KEYWORDS:

THA; nerve; nerve decompression; nerve release; sciatic nerve palsy; total hip arthroplasty

PMID:
27884417
DOI:
10.1016/j.arth.2016.10.032
[Indexed for MEDLINE]

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