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Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty

  • Symposium: Complications of Hip Arthroplasty
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Although injury to the lateral femoral cutaneous nerve (LFCN) is a known complication of anterior approaches to the hip and pelvis, no study has quantified its’ incidence in anterior arthroplasty procedures.

Questions/purposes

We therefore defined the incidence, functional impact, and natural history of LFCN neuropraxia after an anterior approach for both hip resurfacing (HR) and primary total hip arthroplasty (THA).

Methods

We followed 132 patients who underwent an anterior hip approach (55 THA; 77 HR). We administered self-reported questionnaires for sensory deficits of LFCN, neuropathic pain score (DN4), visual analog scale, as well as SF-12, UCLA, and WOMAC scores at one year postoperatively. A subset of 60 patients (30 THA; 30 HR) was evaluated at two time intervals.

Results

One hundred seven patients (81%) reported LFCN neuropraxia with a mean severity score of 2.32/10 and a mean DN4 score of 2.42/10. Hip resurfacing had a higher incidence of neuropraxia as compared with THA: 91% versus 67%, respectively. No functional limitations were reported on SF-12, WOMAC, or UCLA scores. Of the subset of 60 patients followed over an average of 12 months, 53 (88%) reported neuropraxia at the first followup interval with only three (6%) having complete resolution at second followup. Improvement in DN4 scores was observed over time: 3.6 versus 2.5, respectively.

Conclusions

Although LFCN neuropraxia was a frequent complication after anterior approach THA, it did not lead to functional limitations in our patients. A decrease in symptoms occurred over time but only a small number of patients reported complete resolution.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Heather Belanger RN, BScN, and Gillian Parker, BSc (Ottawa Hospital–General Campus, Ottawa, ON, Canada) for their assistance with data collection and the coordination of this research project.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada

    Krista Goulding MD, Paul E. Beaulé MD, FRCSC, Paul R. Kim MD, FRCSC & Anna Fazekas MA

  2. University of Ottawa, Head of Adult Reconstruction, The Ottawa Hospital, 501 Smyth Road, CCW 1646, Box 502, Ottawa, ON, K1H 8L6, Canada

    Paul E. Beaulé MD, FRCSC

Authors
  1. Krista Goulding MD
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  2. Paul E. Beaulé MD, FRCSC
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  3. Paul R. Kim MD, FRCSC
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Correspondence to Paul E. Beaulé MD, FRCSC.

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Each author certifies that his or her institution has approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

Appendix 1: Self-reported antero-lateral thigh numbness

Appendix 1: Self-reported antero-lateral thigh numbness

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Goulding, K., Beaulé, P.E., Kim, P.R. et al. Incidence of Lateral Femoral Cutaneous Nerve Neuropraxia After Anterior Approach Hip Arthroplasty. Clin Orthop Relat Res 468, 2397–2404 (2010). https://doi.org/10.1007/s11999-010-1406-5

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