Pinning* One’s Hopes on a Hip Replacement – Leg Lengthening and Nerve Injury

PUBLISHED 30 Mar 2018

Over 40,000 hip replacements are performed in Australia each year. The numbers of such surgeries are steadily rising given that the baby boomers are now in their late 60’s and 70’s, the time in life when such surgery is typically performed.

Hip replacements are statistically among the most successful type of arthroplasty (joint replacement surgery). Amazing advances have occurred since the first hip replacements were attempted after the First World War, using animal the bones or bones or cadavers. The first robot assisted hip replacement occurred in Australia in Brisbane in 2016.

Despite the high frequency and success rates of hip replacement surgery in Australia, patients are still left from time to time with less than ideal outcomes. One of those adverse outcomes is footdrop – where a person is unable to bend their foot back following surgery. Footdrop is the telltale sign of nerve damage, in particular to the peroneal nerve (which runs down the outside of the calf). Peroneal nerve damage can occur in a variety of way, and must always be guarded against where leg lengthening results from hip replacement surgery.

Leg lengthening after hip replacement is common. It may be desirable as a result of surgery to equalise leg length, may arise because the leg was actually shortened by a disease or condition pre-surgery, or can result from the surgeon maximising function in the joint at the expense of needing to lengthen the leg. Some leg lengthening may be tolerable or even desirable, however beyond a reasonable limit, serious consequences are likely to occur. A reasonable limit for leg lengthening, within which serious consequences are not likely to arise, is 10mm. Leg lengthening of greater than 10mm is likely to give rise to symptoms including tightness, pain, limping, and low back pain. In more serious cases, permanent foot drop may occur.

Where foot drop is identified following surgery, immediate steps should be taken to identify its cause. If leg lengthening is the culprit, removal of a section of thigh bone (osteotomy) should at least be considered. Some hip replacement surgeries, where the shape of the thigh bone makes excessive leg lengthening a typical outcome, should not be attempted by a surgeon who is not capable of performing a complicated osteotomy at the end of the thigh bone.

If caught early and treated, foot drop may be temporary or reduced in severity as the stretching of the peroneal nerve is eased. If left untreated, patients’ may be left with the potentially devastating impact of foot drop for the remainder of their lives.

If you, a family member or friend has had a hip replacement and suffered a permanent injury as a result, the surgeon is highly unlikely to explain to you that a mistake has occurred, and may even advise you that your symptoms are unavoidable – “just one of those things”. At least where excessive leg lengthening after hip replacement is concerned, a finding of medical  negligence is reasonably likely, and injuries resulting from excessive leg lengthening fairly compensated.

At Gerard Malouf and Partners Compensation Lawyers we have assisted thousands of injured people in your position. So feel free to contact Gerard Malouf and Partners Compensation Lawyers for a no obligation discussion of your circumstances by calling 1800 004 878 or complete our email enquiry form on the website.

Call us now on 1800 004 878 to book a free appointment with one of my compensation experts, or email your enquiry.