The Journal of Arthroplasty, Volume 34, Issue 8, 1787 - 1792

Risk Factors for Peripheral Nerve Injury After 207,000 Total Hip Arthroplasties Using a New York State Database (Statewide Planning and Research Cooperative System)

Christ, Alexander B. et al.
Hip

Background

Peripheral nerve injury (PNI) is a devastating complication following total hip arthroplasty (THA). The purpose of this study was to identify risk factors for PNI after THA using a New York Statewide Planning and Research Cooperative System (SPARCS).

Methods

The SPARCS database was queried to identify patients who had undergone THA from 1996 to 2011. Patient demographics, medical history, surgical details, hospital characteristics, and in-hospital complications were recorded. Cases in which a new unilateral PNI was identified were compiled, as were control cases in which a new PNI did not occur. The characteristics of cases and controls underwent univariate testing and a multivariate logistic regression using Akaike information criterion model selection to identify risk factors for the development of PNI after THA.

Results

207,981 cases were identified, and 487 were coded as having a new PNI. Preexisting spinal conditions (odds ratio [OR] = 2.55, confidence interval [CI] = 1.61-3.83) were strongly correlated with the development of PNI postoperatively, as was dislocation (OR = 2.58, CI = 1.01-5.30) and diabetes with chronic complications (OR = 2.26, CI = 0.96-4.43). Younger age, in-hospital complications, and thromboembolic events were also associated with postoperative PNI.

Conclusion

The incidence of PNI after THA was consistent with previous large-scale studies but may under-represent the true incidence because of undercoding inherent in large database studies. Previous spine disorder, chronic diabetes, younger age, and in-hospital postoperative complications all increased the risk of PNI. This study can help health-care providers and systems identify patients at higher risk of this serious complication.

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