Variability in Locations of Hip Neurovascular Structures and Their Proximity to Hip Arthroscopic Portals

Variability in Locations of Hip Neurovascular Structures and Their Proximity to Hip Arthroscopic Portals

Authors: Watson JN, Bohnenkamp F, El-Bitar Y, Moretti V, Domb BG
DOI: 10.1016/j.arthro.2013.12.012

Purpose

To measure distances between key neurovascular structures (LFCN, femoral nerve, sciatic nerve, femoral artery) and hip arthroscopic portal landmarks, assessing variation by demographics.

Methods

MRI analysis in 100 patients; distances correlated with BMI, weight, and race.

Key Findings

• The lateral femoral cutaneous nerve (LFCN) is closest to arthroscopy portals and at highest risk.
• Significant variability in neurovascular anatomy depending on patient demographics.
• BMI, weight, and race significantly affect distances.
• LFCN shows greatest variability and proximity to portals.

Conclusion

Significant anatomic variability exists in neurovascular structures near hip arthroscopy portals; the LFCN is most vulnerable during portal placement.

What Does This Mean for Providers?

• Preoperative imaging and careful patient assessment are vital.
• Adjust portal placement considering patient BMI, weight, and racial anatomy variations.
• High vigilance to protect LFCN during portal creation to minimize nerve injury.