Orthopedic Surgery Expert Evaluates Post-Hip Replacement Foot Drop

This case involves a female patient who underwent a total hip replacement in order to repair a serious injury to her right hip. Post-operatively, the patient developed foot drop which was not present prior to the operation. She also complained of a burning sensation in the lower part of the left leg extending down into the rear surface of the foot. She was discharged and asked to follow-up a few days later, at which point symptoms were expected to resolve. Over a year later, however, her condition had not improved.

Question(s) For Expert Witness

1. Do you routinely treat patients similar to the one described in the case? Please explain.

2. Have you ever had a patient develop the outcome described in the case? If so, please explain.

3. Do you believe this patient may have had a better outcome if the care rendered had been different?

Expert Witness Response E-011984

I do routinely see such patients after total hip replacements and with avascular necrosis. I am aware of this complication which is a sciatic or peroneal nerve injury and is well described. I have not personally had one of my patients experience this complication but I have examined such patients of other physicians. Sometimes this complication resolves spontaneously over time as the underlying cause is resolved, though at the same time there are also reports of surgically exploring the peroneal nerve. Electromyography and nerve conduction studies are also important to localize the level of injury in order to provide an effective diagnosis and treatment. I am experienced total joint surgeon, and I have been published on avascular necrosis. I am currently Research Director of the Joint Replacement Center at a major university medical center.