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Review Question - QID 6049

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QID 6049 (Type "6049" in App Search)
Which of the following factors increases the risk of sciatic nerve injury in primary total hip arthroplasty (THA)?

Male gender

1%

7/667

Anterolateral approach

1%

7/667

Posterior superior quadrant acetabular screw placement

13%

89/667

Osteonecrosis

1%

7/667

Developmental dysplasia of the hip

83%

554/667

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Injury to the sciatic nerve is a relatively rare but serious complication of THA. Dissection of the sciatic nerve is not typically done during primary THA, although the nerve can be identified during the surgical approach. An anterolateral approach to THA would not necessarily be associated with any greater incidence of sciatic nerve injury than other approaches. Screw fixation for the acetabular component is often a matter of surgeon preference. Provided that the anatomic safe zones for screw fixation (posterior inferior and posterior superior) are recognized, injury to the sciatic nerve from acetabular screws can be minimized. Restoration of anatomic length is important in primary THA. Overlengthening can result in sciatic nerve palsy. Developmental dysplasia of the hip can lead to a congenitally shortened extremity with concomitant congenital shortening of the associated neurovascular structures. Overlengthening of the extremity during THA for developmental dysplasia of the hip can lead to sciatic palsy. Osteonecrosis is not an associated risk factor for sciatic nerve palsy.

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