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SURGICAL TREATMENT OF NEUROMA POST TOTAL HIP REPLACEMENT WITH SELECTIVE LATERAL FEMORAL CUTANEOUS NEURECTOMY: A REVIEW OF 5 CASES.



Abstract

This paper describes the surgical indications and technique for lateral femoral cutaneous neurectomy in the hip following formation of a neuroma post surgery.

We would like to present a single surgeon series of the treatment of localised trochanteric pain post total hip replacement. It is believed that in certain cases localised pain in the line of the scar is attributable to formation of a neuroma of the posterior branch of the lateral femoral cutaneous nerve of the thigh.

Method We have reviewed a consecutive series of 5 patients who underwent this procedure for unremitting pain following THR. Of the 5 patients 4 underwent unilateral neurectomy and one underwent a bilateral neurectomy. All had persistent pain before the operation with a positive Tinnel’s test.

Results Of all the patients, 4 said that their pain was improved after the operation and would undergo the operation again. One had no improvement at all. None were worse after the operation.

Conclusion We believe selective neurectomy to be a good procedure in this often, difficult clinical situation.

Several case reports will highlight the findings on history and examination and the technique used.

Editoral Secretary Mr Peter Howard. Correspondence should be addressed to BHS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN.