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Guillain–Barré Syndrome Mimicking Nerve Injury After Total Hip Arthroplasty

  • Case Report
  • Published:
HSS Journal ®

Abstract

Background

Guillain–Barré syndrome (GBS) is a rare, acute, inflammatory demyelinating polyneuropathy with a presentation of progressive ascending motor weakness of the extremities, which may extend to the respiratory muscles and require mechanical support.

Case Description

This case describes a healthy male who developed GBS 1 week following otherwise an uncomplicated bilateral total hip arthroplasty surgery. The diagnosis was made based on physical exam significant for bilateral lower extremity weakness and diffuse arreflexia, and confirmed by nerve conduction studies. There were no effects on respiratory function, and the patient underwent a gradual recovery, with near complete return of motor function by 10 weeks following surgery and no functional deficits at 1 year following surgery. Functional activity levels are maintained 4 years postoperatively.

Literature Review

A literature review is presented. While GBS has been described in the literature following several different forms of surgery and anesthesia, cases after orthopedic surgery are exceedingly rare.

Purposes and Clinical Relevance

This case demonstrates that GBS may occur following orthopedic, including total joint arthroplasty, surgery. The presentation of GBS can be variable, but the hallmarks are areflexia and diffuse ascending weakness, with or without sensory symptoms. Rapid diagnosis and treatment are critical for preventing disability and life-threatening sequelae.

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Author information

Authors and Affiliations

  1. Pediatric Orthopaedic Surgery, Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA, 02115, USA

    Benton E. Heyworth MD

  2. Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th St, New York, NY, 10021, USA

    Peter D. Fabricant MD, Burak Beksac MD & Eduardo A. Salvati MD

  3. Orthopaedic Surgery, Seton Hall University, St. Joseph’s Regional Medical Center, 703 Main St, Paterson, NJ, 07503, USA

    Mark M. Pizzurro MD

Authors
  1. Benton E. Heyworth MD
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  2. Peter D. Fabricant MD
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  3. Mark M. Pizzurro MD
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  4. Burak Beksac MD
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  5. Eduardo A. Salvati MD
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Corresponding author

Correspondence to Peter D. Fabricant MD.

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Conflict of Interest Statement

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Ethical Statement

Each author certifies that his or her institution has approved the reporting of this cases, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participating in the study was obtained.

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Heyworth, B.E., Fabricant, P.D., Pizzurro, M.M. et al. Guillain–Barré Syndrome Mimicking Nerve Injury After Total Hip Arthroplasty. HSS Jrnl 7, 286–289 (2011). https://doi.org/10.1007/s11420-011-9201-8

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  • DOI: https://doi.org/10.1007/s11420-011-9201-8

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