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Meralgia paresthetica of the contralateral leg after total hip arthroplasty.
MedLine Citation:
PMID:  20415307     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
In the United States, total hip arthroplasty (THA) is typically performed with the patient in the lateral decubitus position. Positioning of the morbidly obese patient can be technically challenging and may require special positioning equipment. Although the increased incidence of complications after THA in obese patients has been well documented, neurologic complications in the contralateral limb are rare. This article describes a case of a patient with impairment of the lateral femoral cutaneous nerve in the contralateral leg after THA.A 55-year-old woman with a body mass index of 34.24 kg/m(2) underwent THA in the right lateral decubitus position. Because of her body habitus, a bean-bag positioner was used. Total hip arthroplasty was performed using a direct lateral approach. Intraoperative surgical time was 2.5 hours, and total anesthesia time was 3.5 hours. A few days postoperatively, the patient began to experience "burning and shooting" pain in the contralateral hip, but she did not report this pain until 6 weeks postoperatively. She was treated initially with a single lidocaine injection. When this was ineffective, she was treated with topiramate (100 mg daily) and vitamin B6 (100 mg orally twice daily). The symptoms lessened markedly at 5 months and resolved completely at 9 months postoperatively.Meralgia paresthetica is an uncommon, but known, complication of THA. To our knowledge, it has been reported only in the operative limb. This report reinforces the need for careful positioning to avoid pressure over the anterior superior iliac spine intraoperatively.
Authors:
Chris A Weier; Lynne C Jones; Marc W Hungerford
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Publication Detail:
Type:  Journal Article     Date:  2010-04-16
Journal Detail:
Title:  Orthopedics     Volume:  33     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2013-08-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  IM    
Copyright Information:
Copyright 2010, SLACK Incorporated.
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