Hip Pelvis.  2015 Jun;27(2):120-124. 10.5371/hp.2015.27.2.120.

Sciatic Nerve Palsy Caused by Ruptured and Contracted Short External Rotator Muscles after Primary Total Hip Arthroplasty

• Park JS
• Kim WJ
• Hong CH
• Soh JW
• Nho JH
• Suh YS
• Lee HW

• KMID: 1974391
• DOI: http://doi.org/10.5371/hp.2015.27.2.120

Abstract

Although the incidence of sciatic nerve palsy following total hip arthroplasty is low, this complication can cause devastating permanent nerve palsy. The authors experienced a case of sciatic nerve palsy caused by ruptured and contracted external rotator muscles following total hip arthroplasty in a patient suffering from osteonecrosis of the femoral head. We report this unusual case of sciatic nerve palsy with a review of the literature.

Keyword

Arthroplasty; Hip replacement; Sciatic nerve palsy; Short external rotator muscles

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Hip*
Head
Humans
Incidence
Muscles*
Osteonecrosis
Paralysis
Sciatic Neuropathy*

Figure

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  Fig. 1 (A) Preoperative radiograph. (B) The immediate postoperative radiograph shows good positioning of the prosthesis.

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  Fig. 2 (A) Coronal T2-weighted image of the right hip shows the loss of fascicular architecture and thickened sciatic nerve, which was compressed laterally (white arrow). (B) Coronal T2-weighted image of the left hip shows the normal course of the sciatic nerve. (C) Axial T1-weighted image shows that the sciatic nerve, which adhered to the short rotator muscles and soft tissues, was compressed posteriorly (black arrow).

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  Fig. 3 (A) A close photograph shows that the sciatic nerve (1) was severely tethered and compressed by the ruptured and contracted part of the piriformis muscle, short extensor rotator muscles, and surrounding soft tissue (2). Black arrow indicates the line of ruptured short external rotator muscles. (B) After decompression, the sciatic nerve was freed.

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