Prognostic analysis and risk factors for complete common peroneal nerve injury after total hip replacement and revision via the modified Hardinge approach
10.3760/cma.j.cn115530-20240906-00358
- VernacularTitle:经改良Hardinge入路全髋关节置换术及翻修术后发生完全性腓总神经损伤的危险因素与预后分析
- Author:
Chunyang SU
1
;
Jitong WEI
;
Cuicui GUO
;
Yifan ZHANG
;
Yingzhen WANG
;
Shuai XIANG
;
Hao XU
Author Information
1. 青岛大学附属医院关节外科，青岛 266000
- Publication Type:Journal Article
- Keywords:
Arthroplasty, replacement, hip;
Postoperative complications;
Hip revision;
Modified Hardinge approach;
Common peroneal nerve injury
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(12):1034-1040
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the prognosis and risk factors for complete common peroneal nerve injury after total hip arthroplasty (THA) and revision via the modified Hardinge approach.Methods:A retrospective study was conducted to analyze the clinical data of 11 patients (nerve injury group) who had developed complete common peroneal nerve injury after THA and revision via the modified Hardinge approach at Department of Joint Surgery, The Affiliated Hospital of Qingdao University from April 2016 to April 2022. There were 7 males and 4 females, with an age at the time of surgery of (59.5±10.1) years and a body mass index of (26.1±3.5) kg/m 2. In a 1∶5 ratio, another 55 patients were included in the nerve injury free group who had not developed common peroneal nerve injury after THA or revision and were matched in surgical year, surgical type, surgical approach, prosthesis fixation mode, and chief surgeon. The clinical data were compared between the 2 groups. Variables with P<0.05 were included in a multifactorial logistic regression model to analyze the risk factors for the complete common peroneal nerve injury after THA and revision via the modified Hardinge approach. The time for recovery of nerve function and functional recovery of the common peroneal nerve at the last follow-up were recorded in the nerve injury group. Results:The differences were statistically significant between the 2 groups in the comparisons of drainage tube placement, body mass index, operative time, and postoperative limb lengthening ( P<0.05). The multifactorial logistic regression analysis showed that absence of drainage tube placement ( OR=0.047, 95% CI: 0.003 to 0.680, P=0.025) and long operative time ( OR=1.063, 95% CI: 1.002 to 1.128, P=0.044) were the risk factors for complete common peroneal nerve injury after THA and revision. The 11 patients were followed up for (48.0±22.0) months after operation. The function of the common peroneal nerve recovered fully at postoperative 3, 21, and 24 months respectively in 3 patients, and began to recover at postoperative 2, 3, 10, and 48 months and recovered to muscle strength levels 3, 2, 2, and 1 at the last follow-up in 4 patients respectively. The neurological function of the common peroneal nerve did not recover in 4 patients whose feet drooped significantly during walking to seriously affect their daily life. Conclusions:Absence of drainage tube placement and long operative time are the risk factors for complete common peroneal nerve injury after THA and revision via the modified Hardinge approach. Once complete common peroneal nerve injury occurs, the prognosis is generally poor for the patients.
