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Case Report

Case Report: Femoral Neuropathy Secondary to Total Hip Arthroplasty Wear Debris

Samo K. Fokter¹, Alenka Repše-Fokter² and Iztok Takač³

(1)	Department of Orthopaedic Surgery and Sports Trauma, Celje General Hospital, Oblakova 5, SLO-3000 Celje, Slovenia

(2)	Department for Pathology and Cytopathology, Celje Teaching Hospital, Celje, Slovenia

(3)	University Department of Gynecology and Perinatology, Maribor University Hospital, Maribor, Slovenia

Received: 26 December 2008 Accepted: 5 May 2009 Published online: 19 May 2009

Abstract Femoral nerve palsy after THA is well known, but delayed palsy is rare. We describe a 58-year-old man who had progressive thigh pain, weakness, and numbness develop 13 years after cementless arthroplasty of his left hip. Plain radiographs showed substantial liner wear. MRI of the lumbar spine was unrevealing and EMG showed a peripheral neurogenic process involving the left femoral nerve. The large intrapelvic cystic mass was confirmed by an abdominopelvic CT scan. Percutaneous aspiration of the cyst was performed. Cultures of the fluid were negative and cytopathologic examination showed necrotic debris without malignant cells. Biopsy revealed necrosis and abundant foreign body granulation tissue with polarizable debris. During surgical removal of the cyst, a defect of the inner acetabular wall was noted. After subsequent revision arthroplasty with allograft bone, the patient’s clinical symptoms improved and his EMG returned to normal.

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the reporting of this case report, that all investigations were conducted in conformity with ethical principles of research.

This work was performed at Celje General Hospital, Celje, Slovenia.

Samo K. Fokter
Email: samo.fokter@guest.arnes.si

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