Potential damage to the femoral neurovasculature during approach to the hip

We examined the course of the femoral neurovasculature about the hip to identify safest location for retractor insertion and furthermore demographic populations who are at-risk for injury due to a decreased distance between the hip joint and the femoral neurovasculature.MethodsA total of 100 non-pathologic hip magnetic resonance imaging (MRI) studies from adult patients were included. Patients were chosen at random from our medical center's digital radiographic archive and their demographic data recorded. Mean distances between the anterior acetabular wall and the femoral artery were measured at three axial levels (acetabular dome, superior iliopectineal ridge, and inferior iliopectineal ridge).ResultsOur data showed the femoral neurovascular structures pass closer in proximity to the acetabular wall as they progress distally about the hip. An average direct separation distance of 40.1 mm was seen at the acetabular dome while measurements at the inferior iliopectineal ridge demonstrated an average distance of 20.5 mm. Additionally, statistically significant (p < 0.05) decreases in distances between acetabulum and femoral neurovasculature were found in patients that were female,>45 years-old, <1.7 m, and <75 kg.DiscussionBy undertaking a large-scale MRI evaluation of the femoral neurovasculature about the hip, not only were we able to approximate the location of the femoral neurovascular bundle as it passes the hip joint, but also the safest location fo...
Source: Journal of Arthroscopy and Joint Surgery - Category: Orthopaedics Source Type: research