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The sciatic nerve is highly mobile in the deep gluteal space with hip and even knee movements. [7] For example, hip flexion with knee extension (also called a straight leg raise) causes the sciatic nerve in the deep gluteal space to move 28mm towards the center of the body. [14] Hip movements may also create dynamic impingement between muscles.
Nerve injury is an injury to a nerve.There is no single classification system that can describe all the many variations of nerve injuries. In 1941, Herbert Seddon introduced a classification of nerve injuries based on three main types of nerve fiber injury and whether there is continuity of the nerve. [1]
A sciatic nerve injury occurs between 0.5% and 2.0% of the time during a hip replacement. [7] Sciatic nerve palsy is a complication of total hip arthroplasty with an incidence of 0.2% to 2.8% of the time, or with an incidence of 1.7% to 7.6% following revision.
The sciatic nerve is the most commonly affected nerve, causing symptoms of sciatica. The femoral nerve can also be affected and cause the patient to experience a numb, tingling feeling throughout one or both legs and even feet or a burning feeling in the hips and legs. [ 22 ]
A heavily scrutinized anatomic variation involves sciatic nerve branching around the piriformis using the 6-category classification first described by Beaton and Anson. In this classification, the normal anatomy (type A) seen in about 80% of people is where the sciatic nerve passes under the piriformis muscle at the greater sciatic notch.
The sciatic nerve comprises nerve roots L4, L5, S1, S2, and S3 in the spine. [26] These nerve roots merge in the pelvic cavity to form the sacral plexus and the sciatic nerve branches from that. Sciatica symptoms can occur when there is pathology anywhere along the course of these nerves.