(0/2500)

The sciatic nerve is at risk in hip replacement. It can be cut accidentally, but typically it is stretched excessively during surgery causing numbness in the foot and a foot drop. If this does occur, the foot of the operated leg remains numb after the spinal anesthesia wears off and it is difficult to pull the toes towards the head. This can only occur immediately after the surgery (If you develop numbness or foot drop a week or month after surgery, it is probably being caused by a separate back problem). The deficit may be minor a transient or more complete.

There is no known treatment to make the nerve recover. Younger patients have a higher chance of nerve recovery. Nerves regrow at a rate of 1mm/ day. Therefore if recovery occurs, it may take up to 18 months. Early in the process there may be a burning pain that can be treated with nerve agents such as Lyrica. A brace (spring loaded sports ankle foot orthotic) can be prescribed to help prevent toe dragging. Usually partial recovery occurs. After 18 months, consideration can be given to a tendon transfer operation to return foot function.

The national rate of sciatic injury in THR is 1-2%. During my first 500 HRA I had a 1% rate of this problem. During the last 2500 case we have had none. In THA my rate is 0.1%.