Email this article Electrophysiological patterns of sciatic nerve in patients with arthrosis deformans of the hip
- Authors: Ostrovskij V.V.1, Korshunova G.A.1, Bazhanov S.P.1, Chekhonatskij A.A.1, Tolkachev V.S.1
-
Affiliations:
- V.I. Razumovsky Saratov State Medical University
- Issue: Vol 28, No 2 (2021)
- Pages: 47-54
- Section: Original study articles
- URL: https://bakhtiniada.ru/0869-8678/article/view/71476
- DOI: https://doi.org/10.17816/vto71476
- ID: 71476
Cite item
Abstract
BACKGROUND: Neurological complications in sciatic nerve (SN) after a total hip replacement (THR) are observed in 0.9–3.2% of cases in patients with arthrosis deformans and age-related morphologic changes in SN. These cause the need for SN evaluation before THR. This research was aimed at the evaluation of the initial SN capacity with electrophysiological findings in patients with arthrosis deformans of the hip.
MATERIALS AND METHODS: Electroneuromyography (ENMG) was used to evaluate fibular and tibial nerves M-responses as well as F-waves in 66 patients with dysplastic coxarthrosis and 12 patients with posttraumatic coxarthrosis. The findings were compared to those of the controls.
RESULTS: Changes in ENMG findings for fibular nerve in 49 patients with dysplastic coxarthrosis were bilateral and showed significant difference only from the norm. In 19 of 66 cases (27.9%) low M-responses (р <0.02) were found in the side subject to THR. In 87.3% of cases, the signs of a decrease in the conductivity of proximal segments of the tibial nerve were revealed. In patients with posttraumatic coxarthrosis, the significant decrease in ENMG findings from both fibular and tibial nerves was observed in the affected side, they made up just 42-50% of those in the opposite side. Asymptomatic progress of denervation damage in hip and tibia muscles sometimes required needle EMG to fund the signs of motor innervation disorder. A-waves revealed in 65% of patients suggested local damage to one or both portions of SN.
CONCLUSION: ENMG findings in patients with dysplastic arthrosis of the hip enabled revealing of the signs of neuropathy before surgeries and decreasing the risk of neurologic post-surgery complications.
Keywords
Full Text
##article.viewOnOriginalSite##About the authors
Vladimir V. Ostrovskij
V.I. Razumovsky Saratov State Medical University
Email: sarniito@yandex.ru
ORCID iD: 0000-0002-8602-2715
SPIN-code: 7078-8019
Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, MD, PhD, Dr. Sci. (Med.), neurosurgeon
Russian Federation, 148 Chernyshevskiy str., Saratov, 410002Galina A. Korshunova
V.I. Razumovsky Saratov State Medical University
Email: bib@sarniito.com
ORCID iD: 0000-0003-3648-0141
SPIN-code: 7196-2375
Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, MD, PhD, Cand. Sci. (Med.)
Russian Federation, 148 Chernyshevskiy str., Saratov, 410002Sergey P. Bazhanov
V.I. Razumovsky Saratov State Medical University
Email: baj.s@mail.ru
ORCID iD: 0000-0001-9474-9095
SPIN-code: 2621-4519
Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, MD, PhD, Dr. Sci. (Med.), neurosurgeon
Russian Federation, 148 Chernyshevskiy str., Saratov, 410002Andrey A. Chekhonatskij
V.I. Razumovsky Saratov State Medical University
Email: fax-1@yandex.ru
ORCID iD: 0000-0003-3327-1483
SPIN-code: 1191-2280
Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, MD, PhD, Dr. Sci. (Med.), neurosurgeon
Russian Federation, 148 Chernyshevskiy str., Saratov, 410002Vladimir S. Tolkachev
V.I. Razumovsky Saratov State Medical University
Author for correspondence.
Email: vladimir.tolkache@yandex.ru
ORCID iD: 0000-0001-6580-4403
SPIN-code: 9093-0492
Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, neurosurgeon
Russian Federation, 148 Chernyshevskiy str., Saratov, 410002References
- Veber EV, Vorontsova TN, Bogopolskaya AS, Bezgodkov YuA. Routing of adult patients with pathology of hip and knee joints. Modern problems of science and education. 2017;(2):94. (In Russ).
- Koryak VA, Sorokovikov VA, Svistunov VV, Sharova TV. Epide-miology of coxarthrosis. Siberian Medical Journal. 2013;123(8):39–45. (In Russ).
- Volokitina EA, Zaitseva OP, Kolotygin DA, Vishniakov AA. Local intraoperative and early postoperative complications after endoprosthetics of the hip. Genii Ortopedii. 2009;(3):71–77. (In Russ).
- Gusta A, Jakuszewski M, Kedzierski M. Neurological complication after total hip replacement. Chir Narzadow Ruchu Ortop Pol. 2004;69(3):185–187. (In Polish).
- Su EP. Post-operative neuropathy after total hip arthroplasty. Bone Joint J. 2017;99-B(1 Supple A):46–49. doi: 10.1302/0301-620X.99B1.BJJ-2016-0430.R1
- Safarov JM, Articov KP, Safarov DD. Prevention and treatment of neuropathy of the saddle nerve at endoprosthesis in congenital dislocation of the femoral head. Vestnik Akademii meditsinskikh nauk Tadzhikistana. 2017;(2):56–60. (In Russ).
- Safarov JM. Complications of hip joint endoprosthesis. Avicenna bulletin. 2017;19(4):528–531. (In Russ). doi: 10.25005/2074-0581-2017-19-4-528-531
- Balandina IA, Zheltikova TN, Zheltikov IG, et al. Morphometric characteristics of myelinated fibers of the sciatic nerve. Fundamental research. 2013;(5–1):28–32. (In Russ).
- Melnikov II. Anatomicheskie osobennosti sedalishchnogo nerva na etapakh postnatal’nogo ontogeneza [dissertation abstract]. Ufa; 2012. 26 p. (In Russ).
- Shneider LS. Izmeneniya pozvonochno-tazovykh vzaimootnoshenii u patsientov s displaziei tazobedrennykh sustavov IV stepeni po Srowe pri endoprotezirovanii [dissertation abstract]. Novosibirsk; 2019. 22 p. (In Russ).
- Skoromets AA, German DG, Iretskaya MV, Bradman LL. Tunnel compression-ischemic mono- and multineuropathies. Moscow: GOETAR-Meditsina; 2015. P. 371. (In Russ).
- Gudz AI, Denisov AO, Lasunsky SA, et al. Management of complex acetabulum fractures and their consequences. Khirurgia. 2017;(2):70–76. (In Russ).
- Petrov AB, Ruzanov VI, Mashukov TS. Long-term outcomes of surgical treatment of patients with acetabular fractures. Genii ortopedii. 2020;(3):300–305. (In Russ). doi: 10.18019/1028-4427-2020-26-3-300-305
- Blizkyukov VV. Hip arthroplasty in patients with femoral deformities [dissertation abstract]. Saint Petersburg, 2014. 25 p. (In Russ).
- Kamarudin KI, Hamid MH, Yaacob SS, et al. Incidence of sciatic nerve palsy associated with reconstruction plate fixation of posterior wall and posterior column of acetabulum through posterior approach and its prognosis. MOJ Orthop Rheumatol. 2018;10(6):350–353. doi: 10.15406/mojor.2018.10.00447
- Chekhonatsky AA. Diagnostika i kompleksnoe lechenie porazhenii sedalishchnogo nerva pri perelomakh vertluzhnoi vpadiny [dissertation abstract]. Saratov; 1996. 14 p. (In Russ).
- Mombekov AO. Dostupy k tazobedrennomu sustavu pri endoprotezirovanii i ikh vliyanie na funktsional’nye i otdalennye rezul’taty [dissertation abstract]. Moscow; 2005. 10 p.
- Reshetnikov AN, Zaitsev VA, Korshunova GA, et al. Analysis of neuromuscular and locomotor functions in lower extremities of patients with dysplastic coxarthrosis before and after total arthroplasties. Modern Problems of Science and Education. 2016;(3):30. (In Russ).
- Nickolaev SN. Elektromiografiya: klinicheskii praktikum. Ivanovo: Neirosoft; 2013. P. 275. (In Russ).
- Gekht BM, Kasatkina LF, Samoilov MI, Sanadze AG. Elektromiografiya v diagnostike nervno-myshechnykh zabolevanii. Taganrog: TRTU; 1997. P. 148. (In Russ).
- Fullerton PM, Gilliatt RW. Axon reflexes in human motor nerve fibres. J Neurol Neurosurg Psychiatry. 1965;28(1):1–11. doi: 10.1136/jnnp.28.1.1
- Brown GD, Swanson EA, Nercessian OA. Neurologic injuries after total hip arthroplasty. Am J Orthop (Belle Mead NJ). 2008;37(4):191–197.
Supplementary files
