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BioMed Research International
Volume 2017, Article ID 8361071, 7 pages
https://doi.org/10.1155/2017/8361071
Review Article

Sciatic Nerve Palsy following Total Hip Replacement: Are Patients Personal Characteristics More Important than Limb Lengthening? A Systematic Review

1General Orthopaedic Surgery, Rizzoli Sicilia Department, Rizzoli Orthopaedic Institute, Bagheria, Palermo, Italy
2Clinica Ortopedica e Traumatologica II, Rizzoli Orthopaedic Institute, Bologna, Italy

Correspondence should be addressed to Marcello De Fine; moc.liamg@enifed.ollecram

Received 9 August 2017; Accepted 24 October 2017; Published 15 November 2017

Academic Editor: Patrick Sadoghi

Copyright © 2017 Marcello De Fine et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sciatic nerve palsies are rare but potentially devastating complications, accounting for more than 90% of neurologic injuries following total hip replacement. A systematic literature screening was carried out searching papers evaluating an exclusive population of postarthroplasty sciatic nerve palsies to ascertain (1) the influence of limb lengthening itself on sciatic nerve palsy, (2) the most important risk factors, (3) the long-term prognosis, and (4) the outcomes of different treatments. Fourteen manuscripts were finally included. The wide prevalence of retrospective case series decreased the global methodological quality of the retrieved papers. A hazardous lengthening threshold cannot be surely identified. Developmental dysplasia of the hip and previous hip surgeries are the most frequently recognized risk factors. Rate of full nerve function restoration approximates two-thirds of the cases, independently of the extent of initial neural damage. Poor evidences are available about the best treatment strategy. Well-structured multicentric prospective comparative studies are needed to substantiate or contrast the finding of this review. Anyway, since the onset of palsies is probably due to a combination of individual factors, risk of nerve damage and potential for nerve recovery should be evaluated on an individual basis.