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Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_5 | Pages 120 - 120
1 Mar 2017
Shemesh S Robinson J Overley S Moucha C Chen D
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Intro

Sciatic nerve injury (SNI) is a rare and potentially devastating complication after total hip arthroplasty (THA). Neural monitoring has been found in several studies to be useful in preventing SNI, but can be difficult to practically implement during surgery. In this study, we examine the results of using a handheld nerve stimulator for intraoperative sciatic nerve monitoring during complex THA requiring limb lengthening and/or significant manipulation of the sciatic nerve.

Methods

We retrospectively reviewed a consecutive series of 11 cases (9 patients, 11 hips) with either severe developmental dysplasia of the hip (Crowe 3–4) or other underlying conditions requiring complex hip reconstruction involving significant leg lengthening and/or nerve manipulation. Sciatic nerve function was monitored intra-operatively with a handheld nerve stimulator by obtaining pre- and post-reduction conduction thresholds during component trialling. The results of nerve stimulation were then used to influence intraoperative decision- making (downsizing components, shortening osteotomy).


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_7 | Pages 133 - 133
1 May 2016
Fields A Walsh A Dieterich J Carbonaro C Mcdonough D Walsh M Chen D Bronson M Moucha C
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Background

Several studies have shown that Staphylococcus aureus (S.aureus) nasal colonization is associated with postoperative surgical site infection and that preoperative decolonization can reduce infection rates. Up to 30% of joint replacement patients have positive S.aureus nasal swabs and patient risk factors for colonization remain largely unknown. Many joint replacement patients continue to undergo surgery without being screened.

Study Question

Is there a specific patient population at increased risk of S.aureus nasal colonization?