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The Journal of Bone and Joint Surgery (American) 82:447-8 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Letter to the Editor

Neurovascular Injury in Hip Arthroplasty

Adrian E. Weale, F.R.C.S., F.R.C.S.(Orth) and David G. Lewallen, M.D.

The first 150 words of the full text of this article appear below.

To The Editor:

In the Instructional Course Lecture "Neurovascular Injury Associated with Hip Arthroplasty" (79-A: 1870–1880, Dec. 1997), Lewallen stated that "the type of operative approach used ... has not been shown to influence the observed rates of nerve palsy." However, he then stated that "the sciatic nerve is more at risk [of direct injury] during the posterior approach." Lewallen cited two references3,4 in support of this contention. In fact, Johanson et al.3 reported that the prevalence of neural injury decreased from 0.6 percent to 0.3 percent in the latter half of their study, when their practice changed from the use of a transtrochanteric approach to the use of a posterior approach. The authors thought that this decrease in neural injury reflected "the improvement of technical factors unrelated to the approach." Evidence of the implausibility of this explanation is provided by Robinson et al.9, who had reviewed the same . . . [Full Text of this Article]


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