Biomaterial Database

[The risk of nerve lesions in hip alloarthroplasty]. 2010

M-B Goetz, and D Seybold, and F Gossé, and G Muhr, and B Roetman

Klinik für Orthopädie und Unfallchirurgie, Kreiskrankenhaus Gifhorn GmbH, Gifhorn.

OBJECTIVE Repeated luxations, periprosthetic fractures, infections, and nerve palsies are the most frequent complications of hip alloarthroplasty. Paresis acquired during elective implantation entails considerable restrictions in the quality of life. The risk of sustaining a nerve injury depends upon the initial clinical situation, cases of planned leg lengthening in patients with hip dysplasia and high luxations being particularly at risk. METHODS A Medline search was conducted using the query "nerve palsies during hip prosthesis implantation", yielding 126 publications, of which 18 were used to predict the risk of nerve palsies in cases with simultaneous leg lengthening during total hip arthroplasties according to different preconditions. RESULTS The risk for an acquired nerve lesion during hip alloarthroplasty in arthritis was 0.5 %. In cases of hip dysplasia (with no or moderate leg lengthening during the procedure), the risk was increased to 2.3 %. An even higher risk of 3.5 % was found in cases of revision surgery. According to the literature, the risk of nerve palsies in cases of continuous leg lengthening before THA is raised to 5.9 % with a linear correlation between the amount of leg lengthening and rate of nerve palsies. CONCLUSIONS Neural lesions during single-stage leg lengthening of less than 3 cm in hip alloarthroplasty are uncommon. More extensive lengthening can be achieved with continuous procedures, which should be conducted under clinical monitoring of the peripheral nerves to avert possible nerve injury.

UI	MeSH Term	Description	Entries
D007870	Leg Length Inequality	A condition in which one of a pair of legs fails to grow as long as the other, which could result from injury or surgery.	Inequalities, Leg Length,Inequality, Leg Length,Leg Length Inequalities,Length Inequalities, Leg,Length Inequality, Leg
D010525	Peripheral Nerves	The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium.	Endoneurium,Epineurium,Perineurium,Endoneuriums,Epineuriums,Nerve, Peripheral,Nerves, Peripheral,Perineuriums,Peripheral Nerve
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011475	Prosthesis Failure	Malfunction of implantation shunts, valves, etc., and prosthesis loosening, migration, and breaking.	Prosthesis Loosening,Prosthesis Durability,Prosthesis Migration,Prosthesis Survival,Durabilities, Prosthesis,Durability, Prosthesis,Failure, Prosthesis,Failures, Prosthesis,Loosening, Prosthesis,Loosenings, Prosthesis,Migration, Prosthesis,Migrations, Prosthesis,Prosthesis Durabilities,Prosthesis Failures,Prosthesis Loosenings,Prosthesis Migrations,Prosthesis Survivals,Survival, Prosthesis,Survivals, Prosthesis
D006617	Hip Dislocation	Displacement of the femur bone from its normal position at the HIP JOINT.	Hip Displacement,Hip Dysplasia,Dislocation, Hip,Dislocations, Hip,Displacement, Hip,Displacements, Hip,Dysplasia, Hip,Dysplasias, Hip,Hip Dislocations,Hip Displacements,Hip Dysplasias
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012307	Risk Factors	An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent.	Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D015207	Osteoarthritis, Hip	Noninflammatory degenerative disease of the hip joint which usually appears in late middle or old age. It is characterized by growth or maturational disturbances in the femoral neck and head, as well as acetabular dysplasia. A dominant symptom is pain on weight-bearing or motion.	Coxarthrosis,Osteoarthritis of the Hip,Osteoarthritis Of Hip,Coxarthroses,Hip Osteoarthritis,Osteoarthritis Of Hips
D016343	Monitoring, Intraoperative	The constant checking on the state or condition of a patient during the course of a surgical operation (e.g., checking of vital signs).	Intraoperative Monitoring
D059348	Peripheral Nerve Injuries	Injuries to the PERIPHERAL NERVES.	Peripheral Nerve Injury,Nerve Injuries, Peripheral,Nerve Injury, Peripheral