Revision Total Hip Arthroplasty Performed Through the Hueter Interval

Mast, Nicholas H.; Laude, F.

doi:10.2106/jbjs.j.01736

Cited by 68 publications

(42 citation statements)

References 13 publications

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“…Additionally, if a proximal extension of the anterior approach to the hip joint is necessary, as with pediatric orthopaedic surgery for developmental hip dysplasia 7 or in revision arthroplasty 4,39 , additional damage to the posterior branch of the LFCN must be expected. Under these circumstances, and in cases of a well-expressed posterior branch (posterior-type, 32% of the specimens studied), dysesthesia in the lateral thigh and gluteal region is inevitable.…”

Section: Course O F T H E Lat E R a L Femoral Cutaneous N E Rv E W I mentioning

confidence: 99%

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The Anatomical Course of the Lateral Femoral Cutaneous Nerve with Special Attention to the Anterior Approach to the Hip Joint

Rudin

Manestar

Ullrich

et al. 2016

The Journal of Bone and Joint Surgery

105

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BACKGROUND: Injury to the lateral femoral cutaneous nerve (LFCN) is a risk during the operative anterior approach to the hip joint. Although several anatomical studies have described the proximal course of the nerve in relation to the anterior superior iliac spine (ASIS) and the inguinal ligament, the distal course of the LFCN in the proximal aspect of the thigh has not been sufficiently studied. The aim of this cadaveric study was to examine the branching pattern of the nerve, with special consideration to the anterior approach to the hip joint. METHODS: Twenty-eight cadaveric hemipelves from 18 donors (10 paired and 8 unpaired specimens) were dissected. The LFCN branches were localized proximal to the inguinal ligament and traced distally into the area of the proximal aspect of the thigh. Distribution patterns of the nerve with respect to its relationship to the ASIS and the internervous plane of the anterior approach to the hip joint were recorded. RESULTS: We found 3 different branching patterns of the LFCN: sartorius-type (in 36% of the specimens), characterized by a dominant anterior nerve branch coursing along the lateral border of the sartorius muscle with no, or only a thin, posterior branch; posterior-type (in 32%), characterized by a strong posterior nerve branch; and fan-type (in 32%), characterized by multiple spreading nerve branches of equal thickness. In 50% of the specimens, the LFCN divided into 2 branches superior to the inguinal ligament. Sixty-two percent of the LFCN branches entered the proximal aspect of the thigh medial to the ASIS; 27%, above; and 11%, lateral to the ASIS. The LFCN consistently coursed within the deep layer of the subcutaneous fat tissue. CONCLUSIONS: Injury to branches of the LFCN cannot be avoided in approximately one-third of surgical dissections that use the anterior approach to the hip joint. To protect the anterior branch of the LFCN, the skin incision should be as lateral as possible. The posterior branch of the LFCN is most vulnerable in the proximal aspect of the anterior approach to the hip joint, where it can be expected to course within the deep layer of the subcutaneous tissue. Background: Injury to the lateral femoral cutaneous nerve (LFCN) is a risk during the operative anterior approach to the

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Section: Course O F T H E Lat E R a L Femoral Cutaneous N E Rv E W I mentioning

confidence: 99%

“…T he use of the direct anterior approach has gained popularity in recent years in total hip arthroplasty and the treatment of femoroacetabular impingement [1][2][3][4] . It remains a standard approach to the hip joint in pediatric orthopaedic surgery for developmental hip dysplasia or septic arthritis.…”

mentioning

confidence: 99%

The Anatomical Course of the Lateral Femoral Cutaneous Nerve with Special Attention to the Anterior Approach to the Hip Joint

Rudin

Manestar

Ullrich

et al. 2016

The Journal of Bone and Joint Surgery

105

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show abstract

“…We have no great experience with the antero-lateral approach but even though its dislocation rate is low, we have found more limping after THA in patients with the lateral approach. As well as lessening the rate of posterior hip dislocations this technique allows a proper exposure of the acetabulum (Mast & Laude 2011) and it is widely accepted. In the current literature few reports have compared the extent and location of muscle damage between posterior and the direct anterior approaches (Nakata et al, 2009;Meneghini et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Why Minimally Invasive Surgery in Hip Arthroplasty?

Silvestre¹,

Almeida²,

Renovell³

et al. 2012

Recent Advances in Hip and Knee Arthroplasty

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“…This incision in live patients can be as small as 5 cm but is usually 8-10 cm long. 9,[23][24][25] The skin around the incision was reflected medially and laterally and the LFCN, along with its branches, dissected out ( Figure 4).…”

Section: Orthopaedic Simulationmentioning

confidence: 99%