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Foot Drop (Peroneal Nerve Damage) Caused by Hip Implants

Foot Drop as Complication of Hip SurgeryPeroneal nerve damage (foot drop) associated with hip replacement surgery is a serious disorder suffered by tens of thousands of individuals. The damage usually involves injury to the sciatic nerve arising from a complication occurring during or after hip implant surgery. Like any neurological injury, foot drop can be potentially devastating, requiring nonsurgical orthotics, physical therapy and/or decompression surgery, or other serious complex medical procedure.

Unfortunately, for a variety of reasons, peroneal nerve damage often has minimal potential of recovery even with surgery. Doctors often treat the condition non-surgically using a custom-fitted foot splint (orthotic) allowing the individual to resume nearly normal daily activity. With proper physical therapy, some relief can be found.

Depending on the seriousness of the injury, revision surgery is often recommended immediately or within a few months after the initial hip replacement procedure. Surgical repair often involves nerve grafting, nerve suture, or possible decompression of the nerve at the damaged site. An additional option can include a nerve transfer, where nerve tissue is harvested from a less important lower leg muscle, and relocated at the damaged site to lift the foot.

However, in most cases there is only minimal potential for full recovery of an injury to the peroneal nerve after time has elapsed. Because of that, the patient suffering the disorder will need to consider every option instead of taking an approach based on wait and see.

Recall of Stryker Rejuvenate Hips

Hip replacement surgery is often a leading cause of foot drop. After only being on the market for less than three years, the Stryker ABG II modular and Rejuvenate modular neck hip replacement implants were recalled in June 2012. This was due to a variety of crucial problems caused by the hip implant including corrosion and/or fretting. The significant mechanical and material problems of the device led to a variety of adverse tissue reactions, nerve damage, infection, blood clots, swelling and pain.

To date, numerous other hip replacement manufacturers in addition to Stryker have recalled their implants due to similar issues involving pain, clots, infection and tissue/nerve reactions including foot drop. These manufacturers include Depuy, Zimmer, Smith & Nephew, Biomet and others.

Common Foot Drop Symptoms

Common symptoms of peroneal nerve damage involve a variety of indications that include:

  • Dragging the foot across the ground (toe dragging)
  • Buzzing, prickling (pins & needles) and/or a numb sensation down the leg to the toes
  • Muscle atrophy around the leg
  • Foot drop or steppage (high step) gate or walk
  • The inability to control toe slapping against the ground
  • Exaggerated hip swinging
  • Extensive weakness and pain in the leg, ankles and feet
  • Loss of foot function

Examinations and Testing for Stryker Patients with Peroneal Nerve Damage

A neurological physician might perform a variety of examinations and tests in an effort to isolate the disorder before prescribing optional treatments. An examination may indicate:

  • Foreleg muscles and foot atrophy
  • Significant inability to control muscles in the feet and lower legs
  • Difficulty when lifting the toes and foot, or pointing toes forward

Testing nerve activity often involves:

  • EMG (electromyography) to test muscle electrical activity
  • Nerve conduction test
  • Nerve ultrasound
  • MRI (magnetic resonance imagery)

Extensive testing and evaluation is often based on the suspected cause of the patient’s nerve dysfunction along with any other associated symptom and how it developed. Supplementary testing could include other scans, x-rays and blood tests.

Recommended Treatments and Options

Many patients suffering foot drop are prescribed a variety of treatments aimed at improving independence and mobility. Corticosteroids are often injected at the location of the pain in an effort to reduce swelling and minimize nerve pressure. Often times, surgery is the only option if the disorder does not react to any nonsurgical treatment, there are significant issues with movement or evidence of damage to the nerve axon is evident.

In some cases, surgery can relieve nerve pressure and reduce symptoms. However, this is often only when the disorder is caused directly by pressure on the affected nerve. It is often advised to limit the use of over-the-counter medications when reducing pain to minimize the potential of side effects.

In many situations, the prognosis (outlook) is challenging to predict. In severe cases, the disability caused by the Stryker hip implant may be permanent. While the disorder will likely not shorten the patient’s expected lifespan, it can decrease their ability to walk or run, and may produce permanent minimal sensation in the feet or legs. Other permanent disabilities could include paralysis or weakness in the lower extremity, along with the side effects caused by the drugs prescribed to minimize pain. Because of that, it is advisable to hire an experienced attorney to seek financial recompense from the implant manufacturer and other responsible parties.

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