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Neurological Injury

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Revision Total Hip Arthroplasty
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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.

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References

  1. 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.

    Google Scholar 

  2. Brushart TM. Selective reinnervation of distal motor stumps by peripheral motor axons. Exp Neurol. 1987;97: 289.

    Article  PubMed  CAS  Google Scholar 

  3. Seddon HJ. Three types of nerve injury. Brain. 1943;66: 237–288.

    Article  Google Scholar 

  4. Sunderland S. Factors influencing the course of regeneration and the quality of the recovery after nerve suture. Brain. 1952;75:19.

    Article  PubMed  CAS  Google Scholar 

  5. Sunderland S. Nerves and nerve injuries. 2nd ed. Edinburgh: Churchill-Livingstone, 1978.

    Google Scholar 

  6. 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.

    PubMed  CAS  Google Scholar 

  7. Lundborg G. Limb ischemia and nerve injury. Arch Surg. 1972;104:631.

    Google Scholar 

  8. 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.

    PubMed  CAS  Google Scholar 

  9. Highest WB, Sanders FK. The effects of stretching nerves after suture. Br J Surg. 1943;30:355.

    Article  Google Scholar 

  10. Liu CT, Benda CE, Lewey FH. Tensile strength of human nerves: an experimental physical and histologic study. Arch Neurol Psychiatry. 1948;59:390.

    Article  Google Scholar 

  11. Mitchell SW. Injuries of nerves and their consequences. JB Lippincott: Philadelphia, 1972.

    Google Scholar 

  12. 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.

    PubMed  CAS  Google Scholar 

  13. Schmalzreid TP, Amstutz HC, Dorey FJ. Nerve palsy associate with total hip replacement. J Bone Joint Surg Am. 1991;73:1074–1080.

    Google Scholar 

  14. Amstutz HC, Ma SM, Jinnah RH, Mai L. Revision of aseptic loose total hip arthroplasties. Clin Orthop. 1982;170:21.

    PubMed  Google Scholar 

  15. Solheim LF, Hagen R. Femoral and sciatic neuropathies after total hip arthroplasty. Acta Orthop Scand. 1980;51:531.

    Article  PubMed  CAS  Google Scholar 

  16. Weber ER, Daube JR, Coventry MB. Peripheral neuropathies associated with total hip arthroplasty. J Bone Joint Surg Am. 1976;58:66.

    PubMed  CAS  Google Scholar 

  17. Johanson NA, Pellicci PM, Tsairis P, Salvati EA. Nerve injury in total hip arthroplasty. Clin Orthop. 1983;179:214.

    Article  PubMed  Google Scholar 

  18. Robinson RP, Robinson HJ, Salvati EA. Comparison of the transtrochanteric and posterior approaches for total hip replacement. Clin Orthop. 1980;147:143–147.

    PubMed  Google Scholar 

  19. 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.

    Google Scholar 

  20. 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.

    Google Scholar 

  21. Black DL, Reckling FW, Porter SS. Somatosensory-evoked potential monitored during total hip arthroplasty. Clin Orthop. 1991;262:170–177.

    PubMed  Google Scholar 

  22. 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.

    Google Scholar 

  23. Edwards BN, Tullos HS, Noble PC. Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clin Orthop. 1987;218:136.

    PubMed  Google Scholar 

  24. Leonard MA. Sciatic nerve paralysis following anticoagulant therapy. J Bone Joint Surg Br. 1972;54:152.

    PubMed  CAS  Google Scholar 

  25. 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.

    PubMed  Google Scholar 

  26. Agur AMR, Lee MJ. Grants atlas of anatomy. 9th ed. Baltimore: Williams and Wilkins, 1991.

    Google Scholar 

  27. 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.

    Google Scholar 

  28. 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.

    Article  PubMed  CAS  Google Scholar 

  29. Simmons C Jr, Izant TH, Rothman RH, Booth RE, Balderston RA. Femoral neuropathy following total hip arthroplasty. J Arthroplasty. 1991;6:S59–S66.

    Article  Google Scholar 

  30. Harris WH. Revision for failed, non-septic total hip arthroplasty: the femoral side. Clin Orthop. 1982; 170:8.

    PubMed  Google Scholar 

  31. Stone RG, Weeks LE, Hajdu M, et al. Evaluation of sciatic nerve compromise during total hip arthroplasty. Clin Orthop. 1985;201:26.

    PubMed  Google Scholar 

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© 1999 Springer Science+Business Media New York

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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

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  • 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

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