Abstract
The nervous system exemplifies the highest level of anatomic and physiologic development. It serves to simultaneously choreograph complex musculoskeletal movements, while receiving, deciphering, and transmitting efferent sensory stimuli. Neurologic complications associated with revision total hip arthroplasty are rare occurrences. Their periodic appearance provide dramatic evidence of the serious dysfunction that severely compromises the outcome of total hip arthroplasty. As orthopedic surgeons, we are trained to isolate, protect, and avoid nerves during all surgical procedures, demonstrating great reverence for their fragility and functional significance. Appropriate attention to anatomic detail, awareness of risk factors associated with revision arthroplasty, and avoidance of inappropriate mechanical and postural maneuvers all serve to limit the neurologic complications associated with revision hip arthroplasty. An understanding of neurophysiology and neurodiagnostic technique allow for prompt recognition of neurologic complications and may serve to limit the severity and impact.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Anderson AF, Brushart TM, Harner CD, Pagnani MJ, Ticker JB. Soft-tissue physiology and repair. In: Kasser JR, ed. Orthopaedic knowledge update 5. Rosemont: American Academy of Orthopaedic Surgeons, 1996:3–20.
Brushart TM. Selective reinnervation of distal motor stumps by peripheral motor axons. Exp Neurol. 1987;97: 289.
Seddon HJ. Three types of nerve injury. Brain. 1943;66: 237–288.
Sunderland S. Factors influencing the course of regeneration and the quality of the recovery after nerve suture. Brain. 1952;75:19.
Sunderland S. Nerves and nerve injuries. 2nd ed. Edinburgh: Churchill-Livingstone, 1978.
Lundborg G. Ischemic nerve injury: experimental studies on intraneural microvascular pathophysiology and nerve function in a limb subjected to temporary circulation arrest. Scand J Plast Reconstr Surg Suppl. 1970;6:3–113.
Lundborg G. Limb ischemia and nerve injury. Arch Surg. 1972;104:631.
Lundborg G. Structure and function of the intraneural microvessels as related to trauma, edema formation, and nerve function. J Bone Joint Surg Am. 1975;57:938–948.
Highest WB, Sanders FK. The effects of stretching nerves after suture. Br J Surg. 1943;30:355.
Liu CT, Benda CE, Lewey FH. Tensile strength of human nerves: an experimental physical and histologic study. Arch Neurol Psychiatry. 1948;59:390.
Mitchell SW. Injuries of nerves and their consequences. JB Lippincott: Philadelphia, 1972.
Lundborg G, Rydevik B. Effects of stretching the tibial nerve of the rabbit: a preliminary study of the intraneural circulation and the barrier function of the perineurium. J Bone Joint Surg Br. 1973;55:390.
Schmalzreid TP, Amstutz HC, Dorey FJ. Nerve palsy associate with total hip replacement. J Bone Joint Surg Am. 1991;73:1074–1080.
Amstutz HC, Ma SM, Jinnah RH, Mai L. Revision of aseptic loose total hip arthroplasties. Clin Orthop. 1982;170:21.
Solheim LF, Hagen R. Femoral and sciatic neuropathies after total hip arthroplasty. Acta Orthop Scand. 1980;51:531.
Weber ER, Daube JR, Coventry MB. Peripheral neuropathies associated with total hip arthroplasty. J Bone Joint Surg Am. 1976;58:66.
Johanson NA, Pellicci PM, Tsairis P, Salvati EA. Nerve injury in total hip arthroplasty. Clin Orthop. 1983;179:214.
Robinson RP, Robinson HJ, Salvati EA. Comparison of the transtrochanteric and posterior approaches for total hip replacement. Clin Orthop. 1980;147:143–147.
Weale AE, Newman P, Bannister GC. Nerve injury following total hip replacement. Lateral and posterior approaches compared. J Bone Joint Surg Br. 1996;78:Supp I.
Stillwell WT. Sciatic neurolysis: an adjunct to complex total hip arthroplasty. In: Stillwell WT, ed. The art of total hip arthroplasty. Orlando: Grune & Stratton, 1987;437.
Black DL, Reckling FW, Porter SS. Somatosensory-evoked potential monitored during total hip arthroplasty. Clin Orthop. 1991;262:170–177.
Nercessian OA, Gonzalez EG, Stinchfield FE. The use of somatosensory evoked potentials during revision or reoperation for total hip arthroplasty. Clin Orthop. 1989;243:138–142.
Edwards BN, Tullos HS, Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop. 1987;218:136.
Leonard MA. Sciatic nerve paralysis following anticoagulant therapy. J Bone Joint Surg Br. 1972;54:152.
Fleming RE, Michelsen CB, Stinchefield FE. Sciatic parai- 31. ysis: a complication of bleeding following hip surgery. J Bone Joint Surg Am. 1979;61:37.
Agur AMR, Lee MJ. Grants atlas of anatomy. 9th ed. Baltimore: Williams and Wilkins, 1991.
Birch R, Unwin A, Chen L. Iatropathic lesions of sciatic and femoral nerve from hip arthroplasty. J Bone Joint Surg Br. 1996;78:Supp I.
Mont MA, Dellon AL, Chen F, Hungerford MW, Krackow KA, Hungerford DS. The operative treatment of peroneal nerve palsy. J Bone Joint Surg Am. 1996;78:863–869.
Simmons C Jr, Izant TH, Rothman RH, Booth RE, Balderston RA. Femoral neuropathy following total hip arthroplasty. J Arthroplasty. 1991;6:S59–S66.
Harris WH. Revision for failed, non-septic total hip arthroplasty: the femoral side. Clin Orthop. 1982; 170:8.
Stone RG, Weeks LE, Hajdu M, et al. Evaluation of sciatic nerve compromise during total hip arthroplasty. Clin Orthop. 1985;201:26.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1999 Springer Science+Business Media New York
About this chapter
Cite this chapter
Anas, P.P., Felix, B. (1999). Neurological Injury. In: Bono, J.V., McCarthy, J.C., Thornhill, T.S., Bierbaum, B.E., Turner, R.H. (eds) Revision Total Hip Arthroplasty. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1406-9_52
Download citation
DOI: https://doi.org/10.1007/978-1-4612-1406-9_52
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4612-7131-4
Online ISBN: 978-1-4612-1406-9
eBook Packages: Springer Book Archive