Sciatic Nerve Palsy Caused by Ruptured and Contracted Short External Rotator Muscles after Primary Total Hip Arthroplasty / 대한고관절학회지

Although the incidence of sciatic nerve palsy following total hip arthroplasty is low, this complication can cause devastating permanent nerve palsy. The authors experienced a case of sciatic nerve palsy caused by ruptured and contracted external rotator muscles following total hip arthroplasty in a patient suffering from osteonecrosis of the femoral head. We report this unusual case of sciatic nerve palsy with a review of the literature.

Modified Posterior Approach to Total Hip Arthroplasty

This paper reviews the posterior approach to total hip arthroplasty and introduces the modified short external rotator muscle saving posterior approach, which enhances hip stability after total hip replacement arthroplasty. In total hip replacement arthroplasty, dislocation is the most common early complication. Especially in the posterior approach, dislocation is more common than in the anterior or lateral approach to the hip. However, preservation or meticulous repair of the short rotator could reduce the incidence of posterior hip dislocation after total hip replacement arthroplasty. With a brief review of the posterior approach to the hip, we introduce the short external rotater muscle saving modified posterior approach to total hip arthroplasty.

Posterior Approach to Total Hip Joint Replacement Arthroplasty

This paper was written to review the posterior approach for total hip arthroplasty and to introduce the modified short external rotator muscle saving posterior approach for enhancing the hip stability after total hip replacement arthroplasty. After total hip replacement arthroplasty, dislocation is the most commom early complication. Especially with using the posterior approach, dislocation is more common than that for the anterior or lateral approach to the hip. We report here that saving or meticulously repairing the short rotator could reduce the incidence of posterior hip dislocation after total hip replacement arthroplasty. Along with a brief review of the posterior approach to the hip, we introduce the short external rotator muscle saving modified posterior approach to total hip arthroplasty.

A pitfall for short external rotator preserving THA : A Case Report

The posterior and posterolateral surgical approach has been frequently used for total hip replacement arthroplasty (THA). But there is a risk of dislocation with this method and so several other methods for preventing dislocation have been presented. The short external rotator preserving technique is currently under the limelight and the reported clinical outcomes have been good. But we report here on one case of disruption of the piriformis muscle from the origin site due to excessive tension during total hip arthroplasty with using the short external rotator preserving technique. We think the conventional approach is safer than the short external preserving approach if excessive tension has to be loaded on the short external rotator for obtaining an appropriate intraoperative field for the patient with a large skeletal structure or the obese patient.

Failure of Repaired Short External Rotator Muscles after Total Hip Arthroplasty

Purpose: To determine the incidence and the time to failure of repaired short external rotator muscles through aposterolateral approach in total hip arthroplasties; and to describe the correlation between failure of the repaired short external rotator muscles and the hip dislocation rate. Materials and Methods: Between January 2003 and October 2003, 51 patients (55 cases) were treated with primary, uncemented total hip arthroplasties. The average patient`s age was 51 years (33 men, 19 women). After the short external rotator muscles were repaired, two 26-gauge wires were stitched as a marker to the abductor tendons and short external rotator tendons. The distance between the two opposing reference points was less than 1.2 cm. The distance between the markers was determined on radiographs that were obtained 1 day, 2 weeks, and 3 months post-operatively. A distance of more than 2.5 cm, or an invisible one, indicated failure. Results: Of a total of 52 repaired short external rotator muscles, 45 (86.5%) failed. Twenty-five(48.1%) failed within the first day, 15 (28.8%) within 2 weeks, and 5 (9.6%) within 3 months post-operatively. Regardless of the time of failure of the repaired short external rotator muscles, postoperative hip dislocations did not occur. Conclusion: The repair of short external rotator muscles after total hip arthroplasties has a high failure rate and contributes little to the prevention of hip dislocations.

Avulsion Facture of Short External Rotators in the Proximal Femur: A Case Report

Although avulsion fractures of greater and lesser trochanters rarely develop in hip fractures, avulsion fracture of short external rotators has not reported still online literature. Moreover, avulsion fracture of short external rotators can simulate the intertrochanteric fracture, and is difficult to differentiate from it on plain radiograph. This study is on the case 74-year old male patient who had avulsion fracture of short external rotators, and had the internal fixation with wire by open reduction under the diagnosis of the intertrochanteric fracture.