Abstract Total hip replacement (THR) is a commonly performed procedure for hip fractures and degenerative joint disease, but a variety of postsurgical issues can complicate it. Sciatic nerve palsy, though uncommon, is a disabling complication of THR in the early postoperative period, and there have been few cases in the literature highlighting its delayed onset. We report a case of a 77-year-old male who developed progressively worsening gluteal pain and delayed sciatic neuropathy post-THR. Despite imaging suggestive of lumbar canal stenosis, clinical presentation and electrophysiological testing localized the neuropathy distal to the spine. Ultrasonography (USG) revealed a hypoechoic collection around an inflamed piriformis muscle, and raised inflammatory markers supported the diagnosis of infectious piriformis syndrome. Surgical drainage and antibiotic therapy led to marked clinical improvement. This case underscores the diagnostic value of USG and a multidisciplinary approach in managing chronic pain post-THR.
Kumari et al. (Tue,) studied this question.