O'Brien Seamus, Gallagher Nicola, Spence David, Bennett Damien, Dennison Janice, Beverland David E
Arthroplasty Outcomes Unit, Primary Joint Unit, Musgrave Park Hospital, Stockman's Lane, Belfast, UK.
Hip Int. 2020 Mar;30(2):135-140. doi: 10.1177/1120700019835454. Epub 2019 Mar 26.
Foot drop is a potentially debilitating complication following injury to the sciatic nerve during primary total hip arthroplasty (THA). The aim of this study was to determine the incidence, risk factors and outcome of this complication within one large surgical practice.
We analysed the records of 10,624 primary THAs carried out between January 1993 and November 2017 using a posterior approach. All were under the care of the senior author.
Overall, there were 47 cases (0.44%) of foot drop, but over time the incidence dropped from 0.6% to 0.3% ( = 0.033). Preoperative protrusio acetabulae ( < 0.001), female sex ( < 0.001) and junior grade of surgeon ( < 0.009) were all significant risk factors. In this series, dysplasia was not a risk factor. 1 year postoperatively, 25 (53.2%) had complete recovery, 12 (25.5%) had ongoing sensory deficit but normal power, and 10 (21.3%) had a residual sensory-motor deficit.
Take home message:- In this series, protrusio acetabulae, female sex and junior grade of surgeon were significant risk factors for foot drop following primary THA.
足下垂是初次全髋关节置换术(THA)期间坐骨神经损伤后可能导致功能障碍的并发症。本研究的目的是确定在一个大型外科手术机构中该并发症的发生率、危险因素及预后情况。
我们分析了1993年1月至2017年11月期间采用后入路进行的10624例初次THA的记录。所有病例均由资深作者负责治疗。
总体而言,有47例(0.44%)发生足下垂,但随着时间推移,发生率从0.6%降至0.3%(P = 0.033)。术前髋臼前突(P < 0.001)、女性(P < 0.001)和低年资外科医生(P < 0.009)均为显著危险因素。在本系列中,发育异常不是危险因素。术后1年,25例(53.2%)完全恢复,12例(25.5%)存在持续感觉障碍但肌力正常,10例(21.3%)存在残留的感觉运动障碍。
要点总结:在本系列中,髋臼前突、女性和低年资外科医生是初次THA后发生足下垂的显著危险因素。