<Case Reports>Sciatic nerve entrapment after total hip arthroplasty

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We had report a case of a sciatic nerve entrapment with heterotopic ossification following total hip arthroplasty. Resection of the ossification led to complete recovery. A 59-year-old male, underwent a left cemented total hip arthroplasty due to severe osteoarthritis, and pain was alleviated. He was discharged and was given a follow-up each year thereafter. Nine years after the operation, the patient complained of a grawing pain radiating down ward from the left buttock/hip to the dorsal aspect of the thigh which increased with hip flexion. There was no paresthesia. The sciatic nerve was tender to palpation in the buttock. Radio-graphs consistently showed no signs of loosening of the hip components. Diagnostic injection of local anesthetics in the piriformis muscle alleviated the pain. Since the pain seemed to be sciatic in origin, an exploratory operation of the sciatic nerve was scheduled. The sciatic nerve was exposed through a posterior approach. A small bony protrusion on the ilium was found and over which sciatic nerve rode during with flexion of the hip joint. After the protrusion was removed the patient felt immediate improvement and after five years relief remains virtually complete.
近畿大学の論文