Total Hip Replacement Anterior Approach Nerve Damage

Anterior hip replacement is a common type of total hip replacement.

Total hip replacement anterior approach nerve damage.

The anterior approach through the front of the hip has been utilized as long as the posterior approach but its popularity has grown in the us over the past 10 15 years. Femoral nerve injury is a rare yet serious complication following the anterior approach. During surgery your doctor makes an incision in the front of your hip to reach the hip joint. The popularity of the direct anterior approach for total hip arthroplasty tha has dramatically increased in recent years.

A recent mayo clinic proceedings article links some nerve damage after hip surgery to inflammatory neuropathy. It should not happen and usually is avoided with meticulous dissection. While research is limited many studies seem to suggest that the risk of damage to the major nerves near the hip in particular the sciatic nerve is lower with the anterior approach than with the traditional approaches. Nerve palsy following total hip arthroplasty tha can have a serious effect on a patient s functional prognosis and on cost effectiveness and it is the leading cause of tha associated medical litigation.

Direct anterior total hip arthroplasty tha is an increasingly utilized and patient requested approach for arthroplasty carrying a unique set of complications. A patient considering anterior hip replacement surgery. 5 7 this is because the sciatic nerve runs behind the hip joint so it is not exposed when using the anterior approach. I teach the anterior approach as one of several approaches to the hip joint for thr.

Many patients request this muscle sparing approach for the theorized benefits of quicker recovery and reduced post operative pain. Total hip replacement surgery is regarded as among the most valued developments in the history of orthopedics. However only a few studies focus on femoral nerve palsy fnp following tha with the direct anterior approach daa. Injury to the sciatic nerve can be a result of excessive traction and or pressure in attempting to gain sufficient exposure of the joint during a thr.

Injury to the lateral femoral cutaneous nerve lfcn can have a wide range of clinical symptoms ranging from hypesthesia to painful paresthesia. The most commonly utilized total hip replacement is the posterior approach through the back of the hip which has been performed successfully for decades. Historically nerve damage from hip surgery has been attributed to mechanical factors caused by anesthesiologists or surgeons such as positioning of the patient during surgery or direct surgical injury of the nerves.