Neurophysiologic Intraoperative Monitoring During Revision Total Hip Arthroplasty

Postoperative nerve palsy associated with revision total hip arthroplasty is a serious neurologic complication, occurring in up to 50% of cases. While a variety of intraoperative monitoring techniques have been used to reduce the prevalence of this complication, they are not sensitive or accurate enough to prevent surgical damage to the sciatic nerve. A new, modified intraoperative montage utilizing spontaneously elicited electromyography (sEMG) and near-nerve action potentials (NAPs) was evaluated in a retrospective review of thirty-five consecutive revision total hip arthroplasties.