[page 24] [Orthopedic Reviews 2011; 3:e6] Femoral and obturator nervespalsy caused by pelvic cementextrusion after hip arthroplasty

Cement extrusion into the pelvis with sub-sequent palsy of the obturator and femoral nerves is a rare entity after hip replacement surgery. Cemented fixation of the acetabular cup has been considered as a safe and reliable standard procedure with very good long term results. We present a case of fifty year old female patient after hip arthroplasty procedure which suffered an obturator and femoral nerve palsy caused by extrusion of bone cement into the pelvis. Postoperative X-rays and CT-scan of the pelvis demonstrated a huge mass consist-ed of bone cement in close proximity of femoral and obturator nerves. The surgery charts reported shallow and weak bony sub-stance in postero-superior aspect of the acetabulum. This weak bony acetabular sub-stance may have caused extrusion of bone cement during press-fitting of the polyethylene cup into the acetabulum, and the following damage of the both nerves produced by poly-merization of bone cement. The bone cement fragment has been surgically removed 3 weeks after arthroplasty. The female patient under-went intensive postoperative physical therapy and electro stimulation which resulted in full recovery of the patient to daily routine and almost normal electromyography results