II. Orthopedic Department, Orthopedic Hospital Speising, Speisinger Str. 109, 1130 Vienna, Austria; Division of Orthopedic Surgery, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
II. Orthopedic Department, Orthopedic Hospital Speising, Speisinger Str. 109, 1130 Vienna, Austria; Michael Ogon Laboratory for Orthopedic Research, Orthopedic Hospital Speising, Speisinger Str. 109, 1130 Vienna, Austria.
Orthop Traumatol Surg Res. 2021 Dec;107(8):102956. doi: 10.1016/j.otsr.2021.102956. Epub 2021 May 4.
Lesions of the lateral cutaneous femoral nerve are a reported complication of the direct anterior approach (DAA) for total hip arthroplasty (THA). Little is known about the incidence rates of this lesion. The goal of this study was to answer the following questions: (1) Is the true incidence rate of LFCN lesions after DAA THA known? (2) What are the reasons for the wide range of reported incidence rates in the literature? (3) Are surgeons increasingly aware of the significance of LFCN lesions?
A US Medical Library of Medicine database search was performed for DAA THA. In total, 1261 search results were screened for reported LFCN lesions.
Forty-five studies were included reporting LFCN lesions rates of 0-83%. Subgroup analysis for studies with (group A, 6 studies, n=1113 cases) and without (group B, 39 studies n=16,741) primary focus on the LFCN lesions was performed. Incidence in group A ranged from 14.8-81% (mean 31%) and 0-83% (mean 3.8%) in group B. The difference between the groups was significant (p=0.005). No uniform and time sensitive definition of postoperative LFCN lesions was found in the literature. An analysis of the publication year and the discovered incidence rate showed an increase of incidence rates [r=0.521 (p<0.001, two-tailed)] over time.
Despite the absence of a uniform definition: LFCN lesions after DAA THA are a frequent and, in the past, often underestimated complication.
IV; systematic review of level II to level IV studies.
股外侧皮神经（Lateral Cutaneous Femoral Nerve，LFCN）损伤是全髋关节置换术（Total Hip Arthroplasty，THA）直接前入路（Direct Anterior Approach，DAA）的一种报道并发症。然而，对于这种损伤的发生率知之甚少。本研究旨在回答以下问题：（1）DAA-THA 后 LFCN 损伤的真实发生率是否已知？（2）文献报道的发生率差异如此之大的原因是什么？（3）外科医生是否越来越意识到 LFCN 损伤的重要性？
对美国医学图书馆数据库进行了 DAA-THA 的检索。共筛选出 1261 项检索结果，报告了 LFCN 损伤的发生率。
共有 45 项研究报告了 LFCN 损伤率为 0-83%。对有（A 组，6 项研究，n=1113 例）和无（B 组，39 项研究，n=16741 例）LFCN 损伤作为主要关注点的研究进行了亚组分析。A 组的发生率范围为 14.8-81%（平均 31%），B 组的发生率为 0-83%（平均 3.8%）。两组之间的差异具有统计学意义（p=0.005）。文献中未发现术后 LFCN 损伤的统一且具有时间敏感性的定义。对发表年份和发现的发生率进行分析表明，发生率随时间呈上升趋势[r=0.521（p<0.001，双侧）]。
尽管缺乏统一的定义，但 DAA-THA 后 LFCN 损伤是一种常见的、过去常常被低估的并发症。
IV；对 II 级至 IV 级研究进行系统评价。
