Sciatic Nerve Palsy Due to Hematoma Following Anticoagulation Therapy for Prevention of Venous Thromboembolism after Total Hip Arthroplasty - A Case Report -

Soo-Ho Lee; Gyeong-Bo Sim

doi:10.5371/hp.2013.25.1.77

Journal List > Hip Pelvis > v.25(1) > 1082011

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Lee and Sim: Sciatic Nerve Palsy Due to Hematoma Following Anticoagulation Therapy for Prevention of Venous Thromboembolism after Total Hip Arthroplasty - A Case Report -

Case Report

Hip & Pelvis

Hip & Pelvis 2013; 25(1): 77-81.

Published online: 31 March 2013

DOI: https://doi.org/10.5371/hp.2013.25.1.77

Sciatic Nerve Palsy Due to Hematoma Following Anticoagulation Therapy for Prevention of Venous Thromboembolism after Total Hip Arthroplasty - A Case Report -

Soo-Ho Lee, MD, PhD, Gyeong-Bo Sim, MD

Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea.

Address reprint request to Soo-Ho Lee, MD, PhD. Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Korea. TEL: +82-2-3010-3527, FAX: +82-2-488-7877, shlee2@amc.seoul.kr

Received 24 January 2013 Revised 25 March 2013 Accepted 25 March 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Nerve palsy as a complication of hematoma following total hip arthroplasty (THA) is a rare development. Although rare, this complication can cause permanent nerve palsy. The authors experienced a case of recovery from sciatic nerve palsy after emergency evacuation of a hematoma. The expanding thigh hematoma was due to anticoagulation treatment for prevention of venous thromboembolism after total hip arthroplasty. After 10 months from the operation, the patient regained complete motor power and leads an ordinary life. The authors would like to emphasize the danger of hematoma following anticoagulation therapy for prevention of venous thromboembolism after total hip arthroplasty.

Keywords: Total hip arthroplasty, Hematoma, Sciatic nerve palsy

Figures and Tables

Fig. 1

(A) Preoperative and (B) postoperative anteroposterior radiograph of the total hip.

Fig. 2

(A) Before hematoma evacuation, axial computed tomography scan shows large amount of hematoma between gluteus maximus and vastus lateralis muscle. (B) After hematoma evacuation, axial computed tomography scan shows drastically reduced hematoma between gluteus maximus and vastus lateralis muscle.

References

1. Schmalzried TP, Amstuts HC, Dorey FJ. Nerve palsy associated with total hip replacement. Risk factors and prognosis. J Bone Joint Surg Am. 1991. 73:1074–1080.

2. Kim YH, Cho SH, Kim RS. Drainage versus nondrainage in simultaneous bilateral total hip arthroplasties. J Arthroplasty. 1998. 13:156–161.

3. Cullen C, Johnson DS, Cook G. Re-admission rates within 28 days of total hip replacement. Ann R Coll Surg Engl. 2006. 88:475–478.

4. Pellegrini VD Jr, Sharrock NE, Paiement GD, Morris R, Warwick DJ. Venous thromboembolic disease after total hip and knee arthroplasty; current perspectives in ad regulated environment. Instr Course Lect. 2008. 57:637–661.

5. Hirsh J, Dalen J, Anderson DR, et al. Oral anticoagulants; mechanism of action, clinical effectiveness, andoptimal therapeutic range. Chest. 2001. 119:8S–21S.

6. Schmalzried TP, Noordin S, Amsututz HC. Update on nerve palsy associated with total hip replacement. Clin Orthop Relat Res. 1997. (344):188–206.

7. Fleming RE Jr, Michelsen CB, Stinchfield FE. Sciatic paralysis. A complication of bleeding following hip surgery. J Bone Joint Surg Am. 1979. 61:37–39.

8. Ratliff AH. Vascular and neurologic complications following total hip replacement. Hip. 1981. 276–292.

9. Solheim LF, Hagen R. Femoral and sciatic neuropathies after total hip arthroplasty. Acta Orthop Scand. 1980. 51:531–534.

10. Tysvaer AT. Computerized tomography and surgical treatment of femoral compression neuropathy. Report of two cases. J Neurosurg. 1982. 57:137–139.

TOOLS

Similar articles