Is nerve damage a risk of joint replacement surgery?
Local numbness around the wound is expected but generally not an issue. In addition, today’s modern pain relief techniques involve injection of Novocain-like substances after surgery. This creates 12 to 24 hours of numbness at the surgery site and possibly other portions of the limb without implying injury to the nerve.
More serious nerve injuries can occur but are not a typical complication. Nerve injury can occur in one to two percent of hip replacements, more commonly in revision surgeries as well as with patients born with abnormal anatomy. During surgery, the nerve can be stretched or bruised from retracting tissue or correcting the alignment of the joint, leading to numbness and possibly weakness in the part of the leg that is fed by that nerve. Quite often this stretching or bruising of the nerve will resolve over a six week to six month period.
Neurologic injury occurs in less than one percent of knee replacement surgeries and is often associated with pre-operative contractures and/or malalignment of the knee as well as prior surgeries with scarring around the knee. Tight dressings around the knee have also been associated with compressive nerve damage. Most patients with partial nerve loss will recover but for patients with a combination of sensation and power loss, the prognosis is less favorable.
Physician awareness is the best “cure” for post-surgical nerve loss by avoiding damage to the nerve in the first place.