Meralgia Paresthetica- Neurological Complication in Patients Undergone Total Hip Arthroplasty Using Direct Anterior Approach

Inastasiv P, Stefanovya V and Taixuav N

Published on: 2024-08-26

Abstract

Background And Purpose of the Study: Meralgia paresthetica after total hip arthroplasty (THA) is rare complication in direct anterior approach DAA). It is linked to iatrogenic injury to the lateral femoral cutaneus nerve (LFCN) DAA to the hip joint uses intramuscular and intraneural interval and it is most used approach in the last decade. This approach aims faster recovery of the patient, lower blood loss, and to reduce pain after THA, but has the longest learning curve among others.

Materials and Methods: This is a retrospective single-cohort observational single centre and single surgeon study in the beginning of his learning curve. Only longitudinal skin incision is used by this surgeon. Study gathers information between 2020 and 2024 and it contains 16 patients undergone THA via DAA. Lesion of the LFCN was confirmed by a neurological examination.

Results: Patients were examined on follow-up visits at 2 weeks, 6 weeks, 6 months, 1 and 2 years after surgery. In 8 patients damage to the LFCN was observed. Symptoms had different velocity from mild hipostesia to severe burning pain in the anterolateral thigh. All cases of clinically presenting LFCN injury clinically improved at the 1-year follow-up, with 5 patients fully recovered. 2 patients had still mild symptoms of nerve damage at the 1year follow up. By the 2 year follow up, all the symptoms resolved.

Conclusion: Neurological complications are not as rare but questionably significant in patients undergoing THR via the DAA. Incidental finding of LFCN injury has no effect on the functional outcome of the artificial joint. It can lead to lower subjective satisfaction of patients with the operation, which can be avoided with careful education and management of expectations of the patients.