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The Journal of Bone and Joint Surgery 79:1395-7 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Case Report

Sciatic Neuropathy Secondary to Intrapelvic Migration of an Acetabular Cup. A Case Report*

Z. U. ISIKLAR, M.D.{dagger}, R. W. LINDSEY, M.D.{ddagger} and H. S. TULLOS, M.D.{ddagger}, HOUSTON, TEXAS

Investigation performed at Baylor College of Medicine, Houston


   Introduction
 
Symptomatic or clinically detectable peripheral neuropathy after a total hip arthroplasty is rare, with a prevalence of 0.3 to 1.0 per cent according to one report; however, the total number of hip replacements performed during the period of the study was not provided9. Injury to the obturator, sciatic, or femoral nerve can occur during or after the procedure. In a prospective study of thirty hip arthroplasties in twenty-eight patients, some degree of nerve damage was detectable electromyographically in twenty-one patients (75 per cent)10.

The principal risk factors for neural injury include revision total hip arthroplasty, limb-lengthening, anticoagulation, female gender, and vascular insufficiency4,10. Delayed palsies of the sciatic nerve are usually due to protruded cement or fragments of broken wire1,3,5. However, to our knowledge, delayed sciatica secondary to protrusion of a cemented acetabular cup that had migrated superiorly has not been reported previously.

We report the case . . . [Full Text of this Article]


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P. S. Issack, J. B. Toro, R. L. Buly, and D. L. Helfet
Sciatic Nerve Release Following Fracture or Reconstructive Surgery of the Acetabulum
J. Bone Joint Surg. Am., July 1, 2007; 89(7): 1432 - 1437.
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