How Common Is Nerve Damage With Anterior Approach Hip Replacement?
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- Опубликовано: 15 окт 2024
- Dr. Mast clears up some misunderstandings about nerve damage associated with anterior hip surgeries:
There are multiple studies that show that there's an incidence of lateral femoral cutaneous nerve injury as a consequence of anterior approach hip replacement. This sounds scary, but you should note that this is a SENSORY nerve- which runs across the front of the hip and it goes down and innervates the top of the thigh. This means that ONLY sensation at the top of the thigh is potentially affected.
This means that it's not unusual to experience some sensory disturbances right after surgery, but these generally resolve on their own by three months. There’s a small subset of patients, approximately 15 percent that experience permanent numbness. It’s often hard to predict who will be affected, however we do know that more complex cases or heavier patients that require more retraction are more likely to experience issues resulting from the nerve being stretched (neuropraxia).
It should be stressed that these nerve issues don’t relate to MOTOR nerves which controls your ability to move your foot up and down or to walk or to straighten your leg.
Injuries to motor nerves are actually very rare with this procedure - they are on par with other approaches. In my practice the incidence is about one in a thousand. When this has occurred in my practice it has typically been self-limiting meaning they resolved on their own.
One of the ways of mitigating the risk is making sure you're going to an experienced surgeon - ultimately the more experience an individual surgeon has with a procedure, the less risk of any type of injury. 
Наука
First surgeon I talked to who is one of the most experienced in the area told me risk of nerve injury was 2%. He marketed himself a lot and also told me the retractors didn't cause pain. He lied. I went to another surgeon who was also highly experienced. I ended up 3 nights in the hospital due to low blood pressure that was resolved with blood transfusions - two bags of blood. Now 2 and 1/2 months post surgery I am doing pretty good but do have some nerve pain. I think it is lessening. When at the hospital I had screaming pain two nights. The nurses dealt with me by closing my door. Don't kid yourself - there are staffing problems in hospitals and medical practices and the patients suffer from it.
I totally agree with you.
Appreciate the Doctors honesty. Wish all those commenting all the best.
I had the anterior procedure 4 weeks ago. No pain, no nerve damage. Unbelievable success for me.
I am walking 1 mile (1.6km) without crutches 6 days after surgery. It’s unbelievable 😀
Lucky you! I started having nerve pain right above the knee on my thigh! It got bad about a few weeks after the surgery. I saw another video that was talking about it being an inflammatory neuropathy vs nerve damage from the surgery… I hope it gets better… only one month out. I also had anterior hip surgery
@@peacefulgaia I also had a bad week about 4 weeks after surgery, suddenly could not put weight on the leg at all….
Scary 😱 Now I am 2 month out and it gets a little stiff if I sit to long
My nerve pain was severe for 10 days after the operation. Since starting physio and strengthening the muscles it has decreased....thank goodness. Could not bear to have it permanently.
I can relate. I’m about 3 weeks out and for the first 2 weeks I had terrible nerve pain on the top of my thigh. I was so afraid it was permanent. It is now vague , but still slightly there. Hoping it will go totally away in a few days.
11 months post op hip anterior approach. Moderate pain when lifting leg to get into the car, to put on my pants, or even lift foot off car accelerator to brake. It goes away when lowering leg. No amount of walking or exercise has helped. So disappointed but still better than the arthritic pain pre op. It is what it is.
Holy s@&$ I just typed almost the same thing! We need to talk!
Can anterior approach damage sciatic nerve?
Apparently there is also a possibility of nerve inflammation occurring ~1 month after surgery, not caused by damage during surgery. Immune therapy can help?
Had anterior hip replacement 8 weeks ago, have had femoral nerve symptoms since, it’s getting worse, surgeon is trying to blame my spine, doing MRI tomorrow. If the nerve is injured in the hip area, which I expect so from the surgery, was not like this before surgery, will the MRI reveal the femoral nerve issue or do we need to do MRI of hip in order to confirm?
I had the exact thing happen to me with my hip replacement 6 months ago. My surgeon said the same thing that it was my back. I know it isn't! I did not have this before surgery. I am seeing a neurologist in two weeks. The pain I had following surgery was the most excruciating pain, and like you, I was in the hospital and I, too, was ignored to the point that they would not even help me to the bathroom. Hospitalization is a sad scenario these days.
You need a neurologist who cares and is skilled in either ( confirmed diagnosis first) anesthesizing the nerve or neurosurgeon who can surgically remove the nerve.
I had anterior hip replacement 3 years ago and have suffered with thigh pain to the point of hardly being about to stand on it at times, other times fine. I found out about cutaneous nerve entrapment and a couple exercises that will release the entrapment. I am much better after a few days of this simple exercise. I finally can see the light at the end of the tunnel.
What was the exercise? I believe I'm having this now. Bout 72 hrs post op anterior hip replacement on my right side. Had my left side done like 7 weeks ago and had no issues. This is excruciating.
I think it would be too early for the nerve entrapment, so I would try it just yet but the exercises are hard to explain. Look on utube for cutaneous femoral nerve entrapment exercises and you will find it. I hope you get better because I know how frustrating this is.
@@rdaviskiwi oh yeah I'm definitely not flossing anytime soon
@@rdaviskiwi thanks for pointing me in the right direction friend.
3 years after and nerve pain is worse than the hip was before surgery and no o e told me before surgery this could happen 😢
Sorry to hear that. Where did you have yours done? Was your surgeon experienced? Did you have the anterior approach replacement?
Hope you’re doing better. All the best.
I was told nothing as well. I have lateral femoral cutaneous nerve damage now.
My thigh is numb and I have upper groin Iliopsoas pain whenever I pick up my leg. It’s been almost 5 years and no improvement. Surgeon took two and half hours and needed the large retractors he said. Any suggestions?
I'd suggest getting your bmi to average if you are the least bit pudgy, and slow gentle psoas ( hip flexor) stretches.( search RUclips for) I'm so sorry you are suffering.
Sir, If peroneal nerve compression or damage occurs during hip replacement surgery, is it temporary or a permanent disease?
Thanks for your question. As mentioned in the video - it is usually a self limiting issue but it depends on the cause and severity.
@@doctormast….What exactly does "self limiting" mean?
Had a hip replacement 3 weeks ago and have been experiencing so much nerve pain below my knee to toes. Nothing helps. Surgeon is blaming my previous back surgeries. I’ve experienced nerve pain after my back surgeries but not nearly as painful. My leg is longer than the non operated one now too. I also spasm sensation in back of thigh down calf a lot. I’m regretting surgery. 😢
I am so sorry. Now I'll post mine.
I had my surgery April 10th, I had blood loss and ended up staying a few days in hospital...I had to have 2 blood transfusion. I am in no pain at all, no need for cane or walker, however walking long time I get tired, I go back to work hopefully at the end of August. My surgeon did anterior, right now the top of my butt, after spinal anesthesia is still a little numb and my "love handle" area is still a bit numb....my sciatica is giving issues, not really painful but more so as annoying, my left calf feels like a cramp but it is not. It's all nerves, and my surgeon's assistant and my physical therapist both said that scar tissue has formed around the nerves and what I am experiencing usually happens around the 2nd or 3rd month....my therapist massages the butt down to my calf with hard pressure that sometimes makes me jump outta my skin....but it helps and I do my therapy at home, especially before bedtime to get everything moving as it should....leg lifts, knee bends, and stretches help. Prior to finding this out and getting therapy help I have been losing sleep and having to sleep in my recliner with legs up.....and the other annoying thing is my left leg is a little longer than my right....other than that I feel great!
Sounds like you had a lateral approach instead of anterior?!
Am 6 wks anterior post op. My numbness travels down the outside of the leg (IT Band). My surgeon told me that this could happen.. It is slowly going away but hey....it beats the pain i endured all of my life. I can handle this.
You are lucky indeed . The difference between numbness and excruciating nerve pain is huge.
I still have nerve pain after one month I had my surgery September 6, 2024
Can shunt splints occur after surgery?
I had my surgery 10 months ago and I have terrible pain when I try to lift my leg, like putting on pants or trying to get into the car. I feel like my leg is really screwed up and I’m so mad.
I'd be mad too.
Had thr 2yrs ago/still cant walk/bitter as fck.Docs hopeless
Avoid doctors and hospitals at all cost
After 2 weeks post op I have the classical presentation of Lateral Femorocutaneous Nerve Neuropraxia with numbness and burning pain to the anterior and lateral thigh. No motor problems but quite uncomfortable and sensitive just by minimal friction or touch, which is not even help by Pregabalin. I guess the retractor application for anterior lateral THR and the stretching of the nerve to be blamed for this. Walking after sitting produces an intense burning pain which reaches 8/10 for several minutes.
This is my pain exactly , ( 1 week post op today) and was my pain exactly two years ago after the surgeon ( different surgeon) injured that nerve replacing my other hip. Please check in to let me know how you stand with it now. So sorry.
I still have nerve pain after one month I had my surgery September 6, 2024