Adult patients with history of childhood infection pose a surgical challenge for total hip arthroplasty (THA) due to distorted bony anatomy, soft-tissue contractures, risk of reinfection, and relatively younger age. Therefore, the purpose of the present study was to determine clinical outcome, reinfection rate, and complications in patients with septic sequelae after THA. A retrospective analysis was conducted of 91 cementless THAs (57 male and 34 female) performed between 2008 and 2017 in patients who had history of hip infection during childhood. Clinical outcome was measured using Harris Hip Score (HHS) and Modified Merle d’Aubigne and Postel (MAP) score, and quality of life (QOL) using 12-Item Short Form Health Survey Questionnaire (SF-12) components: Physical Component Score (PCS) and Mental Component Score (MCS); limb length discrepancy (LLD) and radiological assessment of the prosthesis was performed at the latest follow-up. Reinfection and revision surgery after THA for any reason was documented.Aims
Methods
Sciatic nerve palsy following total hip arthroplasty
(THA) is a relatively rare yet potentially devastating complication.
The purpose of this case series was to report the results of patients
with a sciatic nerve palsy who presented between 2000 and 2010,
following primary and revision THA and were treated with neurolysis.
A retrospective review was made of 12 patients (eight women and
four men), with sciatic nerve palsy following THA. The mean age
of the patients was 62.7 years (50 to 72; standard deviation 6.9).
They underwent interfascicular neurolysis for sciatic nerve palsy,
after failing a trial of non-operative treatment for a minimum of
six months. Following surgery, a statistically and clinically significant
improvement in motor function was seen in all patients. The mean
peroneal nerve score function improved from 0.42 (0 to 3) to 3 (1
to 5) (p <
0.001). The mean tibial nerve motor function score
improved from 1.75 (1 to 4) to 3.92 (3 to 5) (p = 0.02).The mean
improvement in sensory function was a clinically negligible 1 out
of 5 in all patients. In total, 11 patients reported improvement
in their pain following surgery. We conclude that neurolysis of the sciatic nerve has a favourable
prognosis in patients with a sciatic nerve palsy following THA.
Our findings suggest that surgery should not be delayed for >
12
months following injury. Cite this article:
