2018 AANS Annual Scientific Meeting-610. Distal Peroneal Nerve Decompression after Sciatic Nerve Injury Secondary to Total Hip Arthroplasty

610. Distal Peroneal Nerve Decompression after Sciatic Nerve Injury Secondary to Total Hip Arthroplasty

Video Transcription

Video Summary

In this video, Dr. Wilson from Stanford discusses a study on distal perineal nerve decompression following sciatic nerve injuries after total hip replacement surgeries. It is mentioned that sciatic nerve injuries occur in about 0.5% of total hip replacement surgeries, resulting in foot drop as the main complication. The recovery rate for these injuries is relatively poor, with studies showing that only about 30-35% of patients recover to at least grade 3 function. The study involved reviewing 37 patients who underwent perineal nerve decompression at the fibular tunnel, and it was found that 65% of patients experienced good dorsiflexion outcomes. Factors that predicted a good surgical outcome were preoperative motor unit potentials in the tibialis anterior or peroneus longus muscles. The procedure was considered low-risk with potential benefits, but it is noted that further studies comparing it to conservative management are needed. The video also addresses the importance of visualizing the nerve injury with imaging studies and exploring proximal injuries if referred early enough. It concludes by cautioning on the need for careful consideration and expertise when performing decompression procedures.

Asset Caption

Thomas J. Wilson, MD

Keywords

distal perineal nerve decompression

sciatic nerve injuries

total hip replacement surgeries

foot drop

recovery rate