The Sciatic Nerve and Your Hip Implant

Hip implant surgery is supposed to relieve pain. In too many cases however, it has the opposite effect – and not simply because they wear out.

The health complications associated with metal-on-metal hip implants is well known and thoroughly documented. What is less well known is the risk of damage to the sciatic nerve, which can leave a patient in excruciating and often untreatable pain.

Mrs. Fran Baxter of the U.K. is one such example. Almost immediately following replacement surgery for her left hip, she began suffering from severe pain that ran from her hip to her foot, causing massive swelling of the left knee.

Small wonder; in case you didn’t know, the sciatic nerves are the primary nerve channels that carry messages from the lower back, through the buttocks and down the legs, all the way to the feet.  Sciatica is a lower back condition that can be caused by spinal disc herniation or any number of lower back conditions that irritate or compress the sciatic nerve.

Injury to the sciatic nerve is also a risk to patients who undergo hip replacement surgery. According to neurologist Dr. Thomas Schmalzried, who works at the St. Vincent Medical Center in Los Angeles, 1% of all patients who undergo hip replacement develop nerve palsy as a result of the surgery. However, this risk rises to 2.5% for those undergoing revision surgery.  And, for those who suffer from developmental hip dysplasia (a deformation or misalignment of the hip due to a degenerative condition), the risk is considerably higher; 5% of these patients wind up suffering from nerve palsy.

Furthermore, women are twice as likely to develop this condition as men.  Speaking at an orthopedic conference in Hawaii a few years ago,  Dr. Schmalried said  that  sciatic palsy in the result of damage to the sciatic nerve in almost 80% of cases – and that the sciatic nerve is the most frequent casualty of hip replacement surgery.

Mrs. Baxter’s story finally had a happy ending. After several years of ineffective treatments with various medications (including morphine and steroids), Mrs. Baxter finally found relief through a type electro-stimulation therapy, known as spinal cord stimulation. This involves the implantation of small electrodes  in the spine that signal the brain to release endorphins, which act as a natural analgesic.

While the procedure is highly recommended in the U.K., there is a severe shortage of pain specialists in that country – and according to an article in the Daily Mail, “local health authorities are reluctant to pay the £24,000 [around $50,000 USD] for the operation.”

And that’s in a nation with government-run, guaranteed health care. If you need such a procedure under  our own privatized, profit-driven, bottom line health care “system,” good luck…

Sources

Davis, Carol. “Eight Years of Back Pain Wiped Out at the Flick of a Switch.” Daily Mail, 22 November 2011.

Schmalzried, TP. “Nerve and Vascular Injuries Associated With Total Hip Arthroplasty.” Presented at Orthopedics Today Hawaii 2008. Jan. 13-16, 2008. Lahaina, Maui, Hawaii. 

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