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Lateral femoral cutaneous nerve injury with the direct anterior approach for total hip arthroplasty

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Abstract

Purpose

Although injury of the lateral femoral cutaneous nerve (LFCN) is a known complication after total hip arthroplasty (THA) via the direct anterior approach (DAA), the impact of this complication on postoperative quality of life (QOL) is unclear. This study aims to investigate the incidence of LFCN injury after DAA for THA, and to determine the impact of LFCN injury on QOL and hip function.

Methods

We prospectively investigated 122 hips operated upon using the DAA regarding the incidence of LFCN injury using self-reported questionnaires, hip functional scores such as the Harris Hip Score (HHS) and the Japanese Orthopaedic Association (JOA) score, and patient-reported outcomes such as the Western Ontario and McMaster Universities Osteoarthritis Index, the Japanese Orthopaedic Association Hip disease Evaluation Questionnaire (JHEQ), and the Forgotten Joint Score-12 (FJS).

Results

LFCN injury was seen in 39 hips (31.9 %). In affected hips, the leading symptom was hypo-aesthesia (46.2 %), followed by tingling or jolt-like sensation (28.2 %). There was no difference in the HHS and JOA score between those with LFCN injury and those without. There was a significant difference in the FJS-12 between the two groups (50.9 ± 25.3 for hips with LFCN injury vs 64.3 ± 25.7 without, p = 0.01). There was a non-significant tendency for patients with LFCN injury to have a lower JHEQ than those without (63.6 ± 19.6 for hips with LFCN injury vs 70.8 ± 22.9 without, p = 0.13).

Conclusions

The incidence of LFCN injury decreased QOL but not hip function after DAA for THA.

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Acknowledgments

No funds were received in support of this study. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan

    Yasuhiro Homma, Tomonori Baba, Kei Sano, Hironori Ochi, Mikio Matsumoto, Hideo Kobayashi, Takahito Yuasa & Kazuo Kaneko

  2. Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Uyayasusi, Chiba, Japan

    Yuichiro Maruyama

Authors
  1. Yasuhiro Homma
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  2. Tomonori Baba
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  3. Kei Sano
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  4. Hironori Ochi
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  6. Hideo Kobayashi
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  8. Yuichiro Maruyama
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  9. Kazuo Kaneko
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Correspondence to Yasuhiro Homma.

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Homma, Y., Baba, T., Sano, K. et al. Lateral femoral cutaneous nerve injury with the direct anterior approach for total hip arthroplasty. International Orthopaedics (SICOT) 40, 1587–1593 (2016). https://doi.org/10.1007/s00264-015-2942-0

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  • DOI: https://doi.org/10.1007/s00264-015-2942-0

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