Table 1. Summary of literature review of cases of delayed neuropathy after total hip arthroplasty.

Case report	Time of presentation	Clinical presentation	Workup	Intervention	Identified injury	Outcome
Fokter et al8	9 y	P: Left groin and thigh pain radiation to the knee S: Hypoesthesia in anteromedial thigh M: Quadriceps weakness R: Loss of patellar reflex	X-ray: Eccentric location of femoral head in shell showing liner wear MRI spine: Normal EMG: Lesion localized to left lumbosacral plexus with denervation in femoral distribution CT: 13-cm intrapelvic cyst	Lower middle laparotomy and removal of pelvic cyst Revision hip arthroplasty with allograft used to repair defect	Wear debris mass	Full recovery of function
May et al	4 mo	S: Mild numbness in foot	None	None	Limb lengthening	Full recovery of function
May et al	5 mo	P: Pain in foot S: Sensory deficit in big toe	EMG	Interpositioning of fat pad between sciatic nerve and acetabular ring	Reinforcement ring implantation and scar tissue	Resolution of pain Developed foot drop 6 mo after reoperation
Bader et al4		S: Numbness in anterior and medial aspect of thigh M: Weak knee extension	EMG: 60% loss of motor conduction in femoral nerve	Nerve separation from scar tissue, removal of granuloma and acetabular ring	Loosening of acetabular implant and migration, fracture of supplemental screw, granuloma formation	Full recovery of sensory function Motor improved to 20% of function
Katsimihas et al9	5 mo	S: Lateral calf, foot, posterior leg R: absent ankle jerk M: Weakness in ankle dorsiflexors, evertors, and invertors	EMG: Sciatic nerve deficit at level of the hip or proximal thigh in tibialis anterior, peroneus longus, and gastrocnemius MRI: Spine, gluteus, and pelvis unrevealing	AFO		Improvement in muscle strength and sensation, not back to baseline
Fischer et al7	7 y	P: Lower buttock, difficulty with ambulation	EMG: Normal CT: Large fluid collection deep to abductor extending through greater sciatic notch Arthrogram: Fistula between joint and pelvic fluid collection	L4–5 foraminotomy IR drainage of fluid collection Removal of fractured polyethylene liner and use of bone allograft, cyst resection, replacement of hardware	Cyst formation from THA wear debris	Resolution of pain Able to ambulate unassisted
Stiehl and Stewart12	6 mo	P: Left foot S: Left foot	Bone scan: No increased uptake EMG: Deficit in gluteus medius, tibialis anterior, flexor digitorum longus, biceps femoris, gastrocnemius	Screw removal, dissection of nerve away from injury site	Pelvic screw migration compressing sciatic nerve	Resolution of pain Numbness persistent Motor function improved to 60%
Asnis et al3	5 y	P: Buttock and thigh S: Posterior thigh M: Hamstring weakness R: Decreased ankle jerk	X-ray: Normal lumbosacral region; pelvis showing wire migration	Lidocaine injection Sciatic exploration showing 2 cm wire within sciatic nerve, epineurium incised and wire removed	Migration of trochanteric wire	Full recovery of function
Edwards et al6	3 y	P: Buttock, posterior thigh to toe S: Dorsum of foot and lateral calf M: Tibialis anterior, extensor digitorum longus, extensor hallicis longus R: Absent ankle jerk	X-ray: Normal EMG: Deficit in tibialis anterior, extensor hallicis longus, short head of biceps femoris Myelogram: Normal	Sciatic nerve exploration; spur of methyl methacrylate found eroding through lateral side of sciatic, neurolysis and shaving down spur	Methyl methacrylate spur	Immediate pain relief Decrease in area of sensory loss No motor recover
Casagrande and Danahy5	7 mo	P: Foot pain M: Peroneal weakness	EMG: Deficit in peroneal and tibial distribution	Sciatic nerve block and lumbar sympathetic block Sciatic exploration showing dense scar tissue, sciatic neurolysis and acrylic mass excision, osteotomy of ischial tuberosity	Acrylic mass, scar tissue	Pain resolved No motor recovery
Leinung et al10	10 y	P: Thigh pain M: Weakness in femoral distribution	CT: Large pelvic mass	Wide excision of tumor	Inflammatory pseudotumor of iliopsoas
Xu et al	2 y	S: Lateral leg and dorsum of foot M: Absence of dorsiflexion, weakness in ankle eversion	MRI: Atrophy of extensor muscles EMG: Deficits in peroneal distribution of sciatic nerve CT: Displacement of screw	Sciatic exploration with dissection of nerve off of screw; shaving down screw	Screw displacement and compression of sciatic nerve	Persistent motor and sensory loss

Abbreviations: AFO, ankle-foot orthosis; CT, computed tomography; EMG, electromyography; IR, interventional radiology; MRI, magnetic resonance imaging; THA, total hip arthroplasty.