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Strain on the human sciatic nerve in vivo during movement of the hip and knee

Fleming, P.
Lenehan, B.
O'Rourke, S.
McHugh, P.
Kaar, K.
McCabe, J. P.
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Publication Date
2003-04-01
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Article
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Citation
Fleming, P. Lenehan, B.; O'Rourke, S.; McHugh, P.; Kaar, K.; McCabe, J. P. (2003). Strain on the human sciatic nerve in vivo during movement of the hip and knee. The Journal of Bone and Joint Surgery 85 (3), 363-365
Abstract
Injuries to the sciatic nerve are an occasional complication of surgery to the hip and acetabulum, and traction is frequently the causative mechanism. In vitro and animal experiments have shown that increased tensile strain on peripheral nerves, when applied for prolonged periods, impairs nerve function. We have used video-extensometry to measure strain on the human sciatic nerve during total hip replacement (THR). Ten consecutive patients with a mean age of 72 years undergoing primary THR by the posterior approach were recruited, and strains in the sciatic nerve were measured in different combinations of flexion and extension of the hip and knee, before dislocation of the hip. Significant increases (p = 0.02) in strain in the sciatic nerve were observed in flexion of the hip and extension of the knee. The mean increase was 26% (19% to 30%). In animal studies increases of this magnitude have been shown to impair electrophysiological function in peripheral nerves. Our results suggest that excessive flexion of the hip and extension of the knee should be avoided during THR.
Funder
Publisher
British Editorial Society of Bone & Joint Surgery
Publisher DOI
10.1302/0301-620x.85b3.13220
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Attribution-NonCommercial-NoDerivs 3.0 Ireland