Hip Replacement Surgery Leads to Non-Functional Foot: A Case Study on Standard of Care

Case Overview

This case involves an adult individual with a history of right lower extremity (RLE) and hip pain, who sought medical attention and was diagnosed with osteoarthritis (OA). As their OA progressed, the individual was referred to an orthopedic surgeon approximately a year later. Initially, they received steroid injections for hip pain but subsequently underwent right hip replacement surgery. Postoperatively, the individual experienced severe complications, resulting in the right foot being non-functional. Following a three-week rehabilitation period, an MRI revealed a diagnosis of right foot drop. This significant impairment has profoundly affected their daily life, necessitating the use of a walker for ambulation. The case raises important questions about the standard of care in hip replacement surgery.

Questions to the Orthopedic Trauma Surgery expert and their responses

How frequently do you perform hip replacement surgery?

I perform hip replacement surgery several times per week.

What are some measures that should be taken intraoperatively to avoid inadvertent nerve injury during hip replacement?

Some measures that should be taken intraoperatively to avoid inadvertent nerve injury during hip replacement include careful retraction of the posterior soft tissues and full knowledge of the anatomical position of the nerve within the surgical field.

About the expert

This expert has over 15 years of experience in the field of orthopedic surgery. He earned his BA in chemistry from Williams College, followed by his MD from the Drexel University College of Medicine. He then completed an internship in general surgery at Cornell University Medical Center, a residency in orthopedic surgery and a fellowship in biomechanical research at the Hospital for Special Surgery, and an additional fellowship in orthopedic trauma surgery at Harborview Medical Center. Today, this expert is board certified in orthopedic surgery and is an active member of several professional organizations, including the Orthopedic Trauma Association, the American Orthopedic Association, and the American Academy of Orthopedic Surgeons. He has published over 175 peer-reviewed articles and 35 book chapters, as well as edited several textbooks. This expert previously served as an assistant and then associate professor of orthopedic surgery at Washington University in St. Louis. Currently, he is a professor of orthopedic surgery, the director of the orthopedic trauma fellowship and research program, the chief of the orthopedic trauma service, and the vice-chairman of orthopedic surgery at a prestigious medical school in California.

E-055218

Specialties:

Orthopedic Trauma Surgery

Hip Replacement Surgery Leads to Non-Functional Foot