Surgical treatment of obturator nerve palsy resulting from extrapelvic extrusion of cement during total hip arthroplasty.

A female patient was successfully treated surgically for obturator nerve palsy resulting from extrapelvic extrusion of cement during total hip arthroplasty. Obturator nerve palsy developed because of the extrapelvic extrusion of cement medially in the anterior part of the incisura acetabuli in the zone of the extrapelvic exit of the obturator tunnel. Compression of the obturator nerve was confirmed by electromyography. After surgical removal of a piece of cement, 2.5 cm in length, which was done 11 months after total hip arthroplasty, and after 6 months of intensive postoperative rehabilitation, the patient was able to return to everyday activities and normal working habits. After 1 year, clinical and electromyography results were almost completely normal. A review of current knowledge regarding obturator nerve injuries resulting from total hip arthroplasty is presented.