Nerve Damage in Hip Surgery Linked to Neuropathy

Neurologists from Mayo Clinic are reporting new findings that link some nerve damage after hip surgery to inflammatory neuropathy. Historically, nerve damage from hip surgery has been attributed to mechanical factors caused by anesthesiologists or surgeons, such as positioning of the patient during surgery or direct surgical injury of the nerves.

In this retrospective case series, researchers examined patients who developed inflammatory neuropathies, where the immune system attacks the nerves, leading to weakness and pain. Inflammatory neuropathies may be treated with immunotherapy.

“Neuropathy after surgery can significantly affect postsurgical outcomes, ” says Nathan Staff, M.D., Ph.D., Mayo Clinic neurologist, in the May 5, 2014 news release. “The good news is that if we’re able to identify patients experiencing postsurgical inflammatory neuropathy, rather than damage caused by a mechanical process, we may be able to provide treatment immediately to mitigate pain and improve overall outcomes.

The study included patients who developed pain and weakness in a limb after undergoing hip surgery where there was no documented direct or traction injury during surgery. Nerve biopsy demonstrated an inflammatory neuropathy in all patients.

Dr. Staff says it is important that physicians understand that nerve damage may be related to an inflammatory issue, and there are some telltale signs for physicians to look for:

• Patient’s neuropathy isn’t immediate, but rather it develops over time
• Severe pain
• Neuropathy progresses
• Different anatomical distribution than expected

“We know new or worsened weakness after hip surgery can be attributed to surgical factors, such as stretching, compression, contusion, hematoma or even transection of the nerve. But now we know that this weakness may be attributed to an inflammatory issue, and it’s important that physicians look for this cause, too, ” says Dr. Staff.