Although the incidence of post-operative nerve palsy after total hip replacement is rare, it is an important complication for the patient. In a retrospective study the results of 2713 hip arthroplasties were reviewed. Sixty-one cases (2.24%) of post-operative neuropathy were identified. 13 of the sciatic nerve, 33 of the peroneal nerve and 15 of the femoral nerve. The risk is significantly higher in revisions (3.06%), especially when exchanging the acetabular component (8.5%) rather than in primary arthroplasties (2.13%). After an average period of 107 months (11-240) from operation, 41 patients with nerve lesions were questioned about their subjective functional capacity: 17% had recovered completely, 39% had noticed an improvement, and in 44% there was no change; 56.1% complained of weakness and had a complete paralysis. In all cases there was dysfunction of sensibility. Another 17.1% had a sensibility defect without weakness. There was pain in 51.2%, paraesthesia in 34.1% and areas of complete anaesthesia in 19.5%. Altogether 61% of the 41 patients had either gait problems or were dependent on orthotic devices. In summary, only about a third of the patients studied achieved a satisfactory degree of functional recovery.
Bien que les lésions nerveuses soient assez rares après l’implantation de prothèses totales de la hanche, il s’agit d’une complication grave pour le patient. Dans une étude rétrospective, on a analysé les résultats de 2723 endoprothèses totales: il y avait 61 cas de neuropathie postopératoires, 13 cas concernaient le nerf sciatique, 33 cas le nerf sciatique poplité externe et 15 cas le nerf crural. Le risque augmente d’une manière plus significative en cas de révision (3,06%) – surtout en cas de changements isolés du cotyle (8,5%) – qu’en cas d’implantation de prothèses primaires. Après une durée moyenne de 107 mois (11 – 240), 41 patients ont été interrogés sur leurs pertes fonctionnelles actuelles: 17% parlaient d’une récupération complète, 39% d’une récupération partielle, et 44% d’une absence de récupération.