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Case Report: Femoral Neuropathy Secondary to Total Hip Arthroplasty Wear Debris

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Clinical Orthopaedics and Related Research®

Abstract

Femoral nerve palsy after THA is well known, but delayed palsy is rare. We describe a 58-year-old man who had progressive thigh pain, weakness, and numbness develop 13 years after cementless arthroplasty of his left hip. Plain radiographs showed substantial liner wear. MRI of the lumbar spine was unrevealing and EMG showed a peripheral neurogenic process involving the left femoral nerve. The large intrapelvic cystic mass was confirmed by an abdominopelvic CT scan. Percutaneous aspiration of the cyst was performed. Cultures of the fluid were negative and cytopathologic examination showed necrotic debris without malignant cells. Biopsy revealed necrosis and abundant foreign body granulation tissue with polarizable debris. During surgical removal of the cyst, a defect of the inner acetabular wall was noted. After subsequent revision arthroplasty with allograft bone, the patient’s clinical symptoms improved and his EMG returned to normal.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Sports Trauma, Celje General Hospital, Oblakova 5, SLO-3000, Celje, Slovenia

    Samo K. Fokter MD, PhD

  2. Department for Pathology and Cytopathology, Celje Teaching Hospital, Celje, Slovenia

    Alenka Repše-Fokter MD, PhD

  3. University Department of Gynecology and Perinatology, Maribor University Hospital, Maribor, Slovenia

    Iztok Takač MD, PhD

Authors
  1. Samo K. Fokter MD, PhD
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  2. Alenka Repše-Fokter MD, PhD
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  3. Iztok Takač MD, PhD
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Corresponding author

Correspondence to Samo K. Fokter MD, PhD.

Additional information

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

Each author certifies that his or her institution approved the reporting of this case report, that all investigations were conducted in conformity with ethical principles of research.

This work was performed at Celje General Hospital, Celje, Slovenia.

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Fokter, S.K., Repše-Fokter, A. & Takač, I. Case Report: Femoral Neuropathy Secondary to Total Hip Arthroplasty Wear Debris. Clin Orthop Relat Res 467, 3032–3035 (2009). https://doi.org/10.1007/s11999-009-0894-7

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  • DOI: https://doi.org/10.1007/s11999-009-0894-7

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