Painful total hip replacement due to sciatic nerve entrapment in scar tissue and lipoma.

Détails

ID Serval
serval:BIB_4E754A713425
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Painful total hip replacement due to sciatic nerve entrapment in scar tissue and lipoma.
Périodique
Musculoskeletal Surgery
Auteur(s)
Wettstein M., Garofalo R., Mouhsine E.
ISSN
2035-5114[electronic], 2035-5114[linking]
Statut éditorial
Publié
Date de publication
2010
Volume
94
Numéro
2
Pages
77-80
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Painful total hip replacement remains a challenging problem because of the large amount of possible diagnoses. We report about a 64-year-old female patient who was misdiagnosed during 4 years as psychiatric. She suffered of excruciating left retrotrochanteric pain after the implantation of a cementless total hip replacement and revision because of recurrent hip dislocations. Walking was limited to short distances using two crutches. The work-up at this time included the usual diagnoses and remained unsuccessful. No loosening, infection or malposition of the prosthesis could be found, and she had no neurologic deficits in her operated leg. An MRI was obtained to visualize the retrotrochanteric soft tissues and showed a tight scar surrounding the sciatic nerve, which was also compressed by an adjacent lipoma. Therefore, she was reoperated on to remove the lipoma and the scar tissue around the sciatic nerve. To decrease the risk of recurrent scarring around the sciatic nerve, an adhesion barrier was applied before closure. One year after the operation, the patient has no neurologic deficit, no more pain and is able to walk unlimited distances without crutches. Scar tissue around the sciatic nerve is frequently observed during revision surgery. However, we feel that sciatic nerve entrapment by scar tissue should be a part of the differential diagnosis of painful THR. MRI may be a useful tool to achieve this diagnosis.
Pubmed
Création de la notice
02/02/2011 14:12
Dernière modification de la notice
20/08/2019 15:04
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