Hip Pelvis.  2018 Jun;30(2):125-128. 10.5371/hp.2018.30.2.125.

Femoral Nerve Palsy due to Noninfectious Iliopsoas Bursitis and Hematoma after Total Hip Arthroplasty: A Case Report

• Seo JS
• Youm JW
• Kim SM

• KMID: 2412695
• DOI: http://doi.org/10.5371/hp.2018.30.2.125

Abstract

Femoral nerve palsy after total hip arthroplasty is an uncommon complication. We present a case report of delayed-onset femoral nerve palsy associated with iliopsoas hematoma and bursitis 10 years after primary total hip arthroplasty in a 57-year-old male patient with avascular necrosis of the femoral head. The patient visited our clinic due to swelling of the inguinal area with sudden-onset knee extension weakness. Radiologic examination at admission revealed suspicion of bursitis and hematoma on iliopsoas muscle. After evacuation of the hematoma and bursitis debridement, the patient's clinical symptoms improved dramatically. This is a rare report of femoral nerve palsy due to noninfectious iliopsoas bursitis and hematoma after total hip arthroplasty.

Keyword

Iliopsoas bursitis; Hematoma; Total hip arthroplasty

MeSH Terms

Arthroplasty, Replacement, Hip*
Bursitis*
Debridement
Femoral Nerve*
Head
Hematoma*
Humans
Knee
Male
Middle Aged
Necrosis
Paralysis*

Figure

• 

  Fig. 1 A 57-year-old male who had received bilateral total hip arthroplasty for avascular necrosis of femoral head. (A) Preoperative anteroposterior radiography hip presented inadequate actetabular cup size was used. (B) Hip trans lateral view showed 10.3° anteversion of acetabular cup and anterior overhanging.

• 

  Fig. 2 The ultrasonography for patient shows 8×5×6-cm hematoma around hip joint.

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  Fig. 3 About 11×5×6-cm mass at right iliopsoas muscle which showed muscle edema and enhancement, mass effect was founded on T2 magnetic resonance imaging view.

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