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首页> 外文期刊>Revue de chirurgie orthopedique et traumatologique >Une petite taille et une faible distance entre le rebord acetabulaire anterieur et le nerf femoral sont des facteurs de risque de paralysie du nerf femoral apres une arthroplastie totale de hanche primaire par 1’approche modifiee de Watson-Jones
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Une petite taille et une faible distance entre le rebord acetabulaire anterieur et le nerf femoral sont des facteurs de risque de paralysie du nerf femoral apres une arthroplastie totale de hanche primaire par 1’approche modifiee de Watson-Jones

机译：Une petite taille et une faible distance entre le rebord acetabulaire anterieur et le nerf femoral sont des facteurs de risque de paralysie du nerf femoral apres une arthroplastie totale de hanche primaire par 1’approche modifiee de Watson-Jones

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Background. - Nerve palsy following total hip arthroplasty (THA) critically impacts patient clinical function. However, few studies have focused on femoral nerve palsy (FNP) following THA via the modified Watson-Jones approach. Previous reports have suggested that THA, regardless of the approach, is associated with several FNP risk factors, including female gender, hip dysplasia, revision surgery, and short stature. Magnetic resonance imaging (MR1) has suggested that a shorter distance between the femoral nerve and the anterior acetabular edge (dFN) is related to FNP after THA. The purposes of this study were: 1) to determine the presumed risk factors through a retrospective investigation of FNP clinical courses; and 2) to identify the relationships between FNP occurrence and the short dFN following primary THA via the modified Watson-Jones approach.Hypothesis. - Short stature is a risk factor for femoral nerve palsy following THA, i.e. a significant difference in dFN exists between patients with and without FNP.Patients and methods. - This retrospective case-control study was performed at a single university hospital. From January 2016 to December 2020, 676 THAs were performed via the modified Watson-Jones approach at our institution. These included 495 THAs performed in the supine position and 181 in the lateral position. In this study, FNP was defined as weakness of the quadriceps femoris (manual muscle test < grade 3) with or without sensory disturbance over the anteromedial aspect of the thigh. The incidence of FNP was calculated. Patient background factors (age, sex, preoperative diagnosis, surgical position, height, weight, body mass index, surgeon experience, type of components, the method of anesthesia, leg lengthening during the surgery, and operation time) were compared between the FNP group and a non-FNP control group. The dFN was measured in T1 -weighted MR1 axial images at the level of the hip center. The distance between the femoral nerve and the anterior acetabular edges, where retractors are commonly placed during surgery, was also measured and compared between the FNP group and the non-FNP control group. The FNP group and non-FNP control group were extracted by 1:4 matching of patient height and weight. All data were statistically evaluated using the Mann-Whitney U test, and p-values less than 0.05 were considered statistically significant.

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