Cates Robert A, Boon Andrea J, Trousdale Robert T, Douge Altagrace, Sierra Rafael J
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
J Hip Preserv Surg. 2019 Jan 3;6(1):77-85. doi: 10.1093/jhps/hny050. eCollection 2019 Jan.
Periacetabular osteotomies (PAOs) are used to treat acetabular dysplasia in younger patients, but are not without morbidity. Lateral femoral cutaneous nerve (LFCN) injuries are commonly associated with the approach for PAOs, but the true incidence and rate of resolution is not known. The purpose of this prospective study was to determine the incidence of LFCN injuries after PAO using an innovative nerve conduction study (NCS) and to report the patient-reported outcomes. We prospectively enrolled 23 patients (24 hips) undergoing PAOs to have pre- and post-operative NCSs at a mean of 12 weeks post-operative. Patients were followed prospectively. Patients were contacted 3 years post-operatively via phone to determine the presence and severity of symptoms. Patient-reported outcome scores were also correlated with patient symptoms. Patients (91%) reported one or more LFCN symptoms post-operatively. The most common symptoms were numbness (91%), tingling (36%), pain (18%) and burning (9%). Patients (67%) had evidence of LFCN injury based on NCSs. Symptoms (40%) resolved 4 months post-operatively. Two-thirds of patients had continued symptoms at 3 years. Only 1 patient required treatment. The incidence of LFCN injury after PAO is 90%, two-thirds of which can be identified objectively by NCS. Numbness is the most common symptom. LFCN symptoms (40%) resolve by 4 months, but two-thirds of patients may continue to have thigh numbness up to 3 years after surgery. Fortunately, symptoms are not clearly associated with outcome score and treatment for this complication is rare.
髋臼周围截骨术（PAO）用于治疗年轻患者的髋臼发育不良，但并非没有并发症。股外侧皮神经（LFCN）损伤通常与PAO的手术入路相关，但真实的发生率和恢复率尚不清楚。这项前瞻性研究的目的是使用创新的神经传导研究（NCS）确定PAO后LFCN损伤的发生率，并报告患者报告的结果。我们前瞻性纳入了23例接受PAO的患者（24髋），在术后平均12周进行术前和术后NCS。对患者进行前瞻性随访。术后3年通过电话联系患者，以确定症状的存在和严重程度。患者报告的结果评分也与患者症状相关。91%的患者术后报告有1种或多种LFCN症状。最常见的症状是麻木（91%）、刺痛（36%）、疼痛（18%）和烧灼感（9%）。67%的患者基于NCS有LFCN损伤的证据。症状在术后4个月缓解的比例为40%。三分之二的患者在3年时仍有持续症状。只有1例患者需要治疗。PAO后LFCN损伤的发生率为90%，其中三分之二可通过NCS客观识别。麻木是最常见的症状。LFCN症状在4个月时缓解的比例为40%，但三分之二的患者在术后3年可能仍有大腿麻木。幸运的是，症状与结果评分没有明显关联，这种并发症的治疗很少见。
