Sciatic nerve entrapment after total hip arthroplasty in a patient with diffuse lipomatosis and developmental dysplasia of the hip: A rare case report

Introduction and importance: Diffuse lipomatosis is rare. In this case, a patient with diffuse lipomatosis and developmental dysplasia of the hip (DDH) underwent total hip arthroplasty (THA). Postoperatively, the patient experienced sciatic nerve entrapment. The lack of treatment experience and related literature makes addressing this complication challenging. Case presentation: A 26-year-old female patient presented to our clinic with developmental dysplasia of the right hip and lower limb malformations. She underwent THA and, one week later, developed contralateral sciatic nerve entrapment, for which she received neurolysis. The patient was diagnosed with diffuse lipomatosis based on pathological results. Four years post-operation, she lives independently and is satisfied with the treatment outcomes. Clinical discussion: This case report aims to illuminate the approach to diagnosing and treating patients with diffuse lipomatosis and DDH. By exploring the elements of this patient's journey to diagnosis and treatment, we aspire to aid future clinicians in navigating the challenges of performing THA for patients with anatomical abnormalities around the hip joint. Once neurological symptoms appear, sciatic nerve entrapment must be considered. Conclusion: Neurological symptoms in the lower limbs following THA in patients with diffuse lipomatosis should prompt consideration of sciatic nerve entrapment. Adjustments in body positioning may be an effective method to prevent nerve entrapment in these patients. Once sciatic nerve entrapment is diagnosed, early surgery neurolysis may reduce the occurrence of sequelae.