Purpose
To measure the distances of pertinent neurovascular structures from bony landmarks
used during hip arthroscopy and compare them among different demographic groups.
Methods
The distances from neurovascular structures to bony landmarks often used during hip
arthroscopy were measured on magnetic resonance images of the hip in 100 patients.
The structures studied include the lateral femoral cutaneous nerve (LFCN), sciatic
nerve, femoral nerve, and femoral artery. These distances were then compared across
different demographic groups, and statistical analysis was performed.
Results
The mean anteroposterior (AP) distance from the tip of the greater trochanter to the
sciatic nerve was 10.32 mm (range, 0 to 23.8 mm). At the level of the superior tip
of the greater trochanter, the mean distances from the anterior superior iliac spine
reference line to the LFCN, femoral nerve, and femoral artery were 6.37 mm (range, −9.8
to 35.9 mm) for medial-lateral, 23.24 mm (range, 3.4 to 67.0 mm) for AP, and 26.34
mm (range, 7.3 to 65.5 mm) for AP, respectively. We found significant differences
in distances for the LFCN, femoral nerve, and femoral artery for weight (P = .003, P = .041, and P = .004, respectively) and body mass index (P = .003, P = .010, and P = .003, respectively), as well as for the LFCN between whites and Hispanics (P = .032). There were also significant differences for the femoral nerve vector between
African Americans and whites (P = .04), as well as between African Americans and Hispanics (P = .04).
Conclusions
We found the LFCN to be the most at-risk neurovascular structure with hip arthroscopy
portal placement. This study also showed that there is wide variability in the locations
of pertinent neurovascular structures across different demographic groups, including
weight, body mass index, and race or ethnicity.
Clinical Relevance
Portal placement during hip arthroscopy carries a risk of neurovascular injury, particularly
to the LFCN. The clinician should be aware of the variability in structure location
with different patient demographic characteristics.
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Article Info
Publication History
Published online: February 24, 2014
Accepted:
December 17,
2013
Received:
June 21,
2013
Footnotes
The authors report the following potential conflict of interest or source of funding: Y.E-B. has received support from Arthrex . B.G.D. receives support from Arthrex and MAKO Surgical for fellowship training and research, and MedWest and Adventist Hinsdale Hospital for research support.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
