How Common Is Nerve Damage Following Anterior Hip Replacement?

Dr. Mast clears up some misunderstandings about nerve damage associated with anterior hip surgeries:

There are multiple studies that show that there’s an incidence of lateral femoral cutaneous nerve injury as a consequence of anterior approach hip replacement. This sounds scary, but you should note that this is a SENSORY nerve– which runs across the front of the hip and it goes down and innervates the top of the thigh. This means that ONLY sensation at the top of the thigh is potentially affected.

This means that it’s not unusual to experience some sensory disturbances right after surgery, but these generally resolve on their own by three months. There’s a small subset of patients, approximately 15 percent that experience permanent numbness.

It’s often hard to predict who will be affected, however, we do know that more complex cases or heavier patients that require more retraction are more likely to experience issues resulting from the nerve being stretched (neuropraxia). It should be stressed that these nerve issues don’t relate to MOTOR nerves which control your ability to move your foot up and down or to walk or straighten your leg.

Injuries to motor nerves are actually very rare with this procedure – they are on par with other approaches. In my practice, the incidence is about one in a thousand. When this has occurred in my practice it has typically been self-limiting meaning they resolved on their own.

One of the ways of mitigating the risk is making sure you’re going to an experienced surgeon – ultimately the more experience an individual surgeon has with a procedure, the less risk of any type of injury. Here are some questions you should ask when selecting your hip replacement surgeon.

Nicholas Mast MD is a board-certified orthopedic surgeon specializing in conditions of the hip and pelvis.

Trained in pelvic and acetabular trauma and reconstruction by some of the best in the field, his treatments range from non-replacement options for the management of hip osteoarthritis to complex revision surgeries and hip preservation techniques including periacetabular osteotomy.

He is the most experienced surgeon in the region in the use of the anterior approach for hip replacement and regularly uses this minimally invasive, fast recovery anterior approach to treat a wide variety of hip conditions.