The anatomical course of the sciatic nerve in relation to different approaches in total hip arthroplasty.
Complication
Nerve injury
Sciatic nerve
Total hip arthroplasty
Journal
International orthopaedics
ISSN: 1432-5195
Titre abrégé: Int Orthop
Pays: Germany
ID NLM: 7705431
Informations de publication
Date de publication:
26 Aug 2024
26 Aug 2024
Historique:
received:
26
05
2024
accepted:
14
08
2024
medline:
26
8
2024
pubmed:
26
8
2024
entrez:
25
8
2024
Statut:
aheadofprint
Résumé
Although sciatic nerve (SN) injury is relatively rare, it is a devastating complication after primary and revision total hip arthroplasty (THA). Therefore, precise localization of the SN is essential for arthroplasty surgeons. We dissected 50 hemipelves from formalin-fixed cadavers. The course and location of the sciatic nerve were investigated in relation to different approaches for THA with the help of anatomical landmarks like the greater trochanter (GT), the iliac tubercle, the ischial tuberosity (IschT), the infrapiriform foramen, and the suprapiriform foramen. We found and exposed the sciatic nerve in all 50 specimens with no sex-specific differences. No SN was encountered up to 22 mm posterior from the GT. The zone affording the highest probability of finding the nerve was posterior to the GT between 32 and 55 mm in 39 (78%) cases, thus defining a danger zone for different approaches for the THA. Special care should be taken with posterior and deep instrument placement between the GT and IschT during THA. Moreover, manipulations in the proximal third of the posterior approach reaching deep and posteriorly should be performed with the utmost care.
Identifiants
pubmed: 39183228
doi: 10.1007/s00264-024-06281-7
pii: 10.1007/s00264-024-06281-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s) under exclusive licence to SICOT aisbl.
Références
Yacoubian SV, Sah AP, Estok DM (2010) Incidence of sciatic nerve Palsy after Revision Hip Arthroplasty through a posterior Approach. J Arthroplasty 25:31–34. https://doi.org/10.1016/j.arth.2008.11.101
doi: 10.1016/j.arth.2008.11.101
pubmed: 19525089
Hasija R, Kelly JJ, Shah NV et al (2018) Nerve injuries associated with total hip arthroplasty. J Clin Orthop Trauma 9:81–86. https://doi.org/10.1016/j.jcot.2017.10.011
doi: 10.1016/j.jcot.2017.10.011
pubmed: 29628688
DeHart MM, Riley LHJ (1999) Nerve injuries in total hip arthroplasty. JAAOS - J Am Acad Orthop Surg 7
Della Valle CJ, Di Cesare PE (2001) Complications of total hip arthroplasty: neurovascular injury, leg-length discrepancy, and instability. Bulletin (Hospital for Joint Diseases (New York, NY) 60:134–142
Schmalzried TP, Amstutz HC, Dorey FJ (1991) Nerve palsy associated with total hip replacement. Risk factors and prognosis. J Bone Joint Surg Am 73
Weale AE, Newman P, Ferguson IT, Bannister GC (1996) Nerve injury after posterior and direct lateral approaches for hip replacement: a clinical and electrophysiological study. J bone Joint Surg Br Volume 78:899–902
doi: 10.1302/0301-620X.78B6.0780899
Thaler M (2021) Response to letter to editor on the anatomical course of the lateral femoral cutaneous nerve in relation to various skin incisions used for primary and revision total hip arthroplasty with the Direct Anterior Approach. J Arthroplasty 36:e19. https://doi.org/10.1016/j.arth.2020.09.001
doi: 10.1016/j.arth.2020.09.001
pubmed: 33446357
Thaler M, Dammerer D, Hechenberger F et al (2020) The anatomical course of the lateral femoral cutaneous nerve in relation to various skin incisions used for primary and revision total hip arthroplasty with the Direct Anterior Approach. J Arthroplasty 1–6. https://doi.org/10.1016/j.arth.2020.07.052
Starke V, Stofferin H, Mannschatz S et al (2020) The anatomical course of the Superior gluteal nerve with regard to the Direct Anterior Approach for Primary and Revision Total Hip Arthroplasty. J Arthroplasty. https://doi.org/10.1016/j.arth.2020.09.045
doi: 10.1016/j.arth.2020.09.045
pubmed: 33071031
Riederer BM, Bolt S, Brenner E et al (2012) The legal and ethical framework governing body donation in Europe – 1 St update on current practice. Eur J Anat 16:1–21
McHanwell S, Brenner E, Chirculescu A et al (2008) The legal and ethical framework governing body donation in Europe-A review of current practice and recommendations for good practice. Eur J Anat 12:1–24
Birke O, Mitchell PD, Onikul E, Little DG (2011) The effect of hip position upon the location of the sciatic nerve: an MRI study. J Pediatr Orthop 31:165–169. https://doi.org/10.1097/BPO.0b013e31820a1345
doi: 10.1097/BPO.0b013e31820a1345
pubmed: 21307711
Gay DP, Desser DR, Parks BG, Boucher HR (2010) Sciatic nerve Injury in Total Hip Resurfacing. A biomechanical analysis. J Arthroplasty 25:1295–1300. https://doi.org/10.1016/j.arth.2009.08.017
doi: 10.1016/j.arth.2009.08.017
pubmed: 19837555
Koga K, Naito M, Akiyoshi Y et al (2002) In vivo study of acute effects of hip and knee positions on blood flow in canine sciatic nerve. Int Orthop 26:296–298. https://doi.org/10.1007/s00264-002-0370-4
doi: 10.1007/s00264-002-0370-4
pubmed: 12378357
Black DL, Reckling FW, Porter SS (1991) Somatosensory-evoked potential monitored during total hip arthroplasty. Clin Orthop Relat Res 262:170–177. https://doi.org/10.1097/00003086-199101000-00024
doi: 10.1097/00003086-199101000-00024
Kanawati AJ, Narulla RS, Lorentzos P et al (2015) The change in position of the sciatic nerve during the posterior approach to the hip. Bone Joint J 97–B:1056–1062. https://doi.org/10.1302/0301-620X.97B8.35746
doi: 10.1302/0301-620X.97B8.35746
pubmed: 26224821
O’Brien S, Gallagher N, Spence D et al (2020) Foot drop following primary total hip arthroplasty. HIP Int 30:135–140. https://doi.org/10.1177/1120700019835454
doi: 10.1177/1120700019835454
pubmed: 30912466
Dietze S, Perka C, Baecker H (2014) Gefäß- Und nervenverletzungen in Der hüftendoprothetik. Orthopade 43:64–69. https://doi.org/10.1007/s00132-013-2126-9
doi: 10.1007/s00132-013-2126-9
pubmed: 24384891
Brown GD, Swanson EA, Nercessian OA (2008) Neurologic injuries after total hip arthroplasty. Am J Orthop (Belle Mead NJ) 37:191–197
pubmed: 18535674
Schmalzried TP, Noordin S, Amstutz HC (1997) Update on nerve palsy associated with total hip replacement. Clin Orthop Relat Research
Navarro RA, Schmalzried TP, Amstutz HC, Dorey FJ (1995) Surgical approach and nerve palsy in total hip arthroplasty. J Arthroplast 10:1–5
doi: 10.1016/S0883-5403(06)80057-4
Wasielewski RC, Crossett LS, Rubash HE (1992) Neural and vascular injury in total hip arthroplasty. Orthop Clin North Am 23:219–235
doi: 10.1016/S0030-5898(20)31733-8
pubmed: 1315014
Putzer D, Haselbacher M, Hörmann R et al (2018) The distance of the gluteal nerve in relation to anatomical landmarks: an anatomic study. Arch Orthop Trauma Surg 138:419–425. https://doi.org/10.1007/s00402-017-2847-z
doi: 10.1007/s00402-017-2847-z
pubmed: 29177540
Realyvasquez J, Singh V, Shah AK et al (2022) The direct anterior approach to the hip: a useful tool in experienced hands or just another approach? Arthroplasty 4:1–12. https://doi.org/10.1186/s42836-021-00104-5
doi: 10.1186/s42836-021-00104-5
pubmed: 35236507
Shubert D, Madoff S, Milillo R, Nandi S (2015) Neurovascular structure proximity to acetabular retractors in total hip arthroplasty. J Arthroplasty 30:145–148. https://doi.org/10.1016/j.arth.2014.08.024
doi: 10.1016/j.arth.2014.08.024
pubmed: 25263247
Apaydin N, Kendir S, Loukas M et al (2013) Surgical anatomy of the superior gluteal nerve and landmarks for its localization during minimally invasive approaches to the hip. Clin Anat 26:614–620. https://doi.org/10.1002/ca.22057
doi: 10.1002/ca.22057
pubmed: 22374811
Ince A, Kemper M, Waschke J, Hendrich C (2007) Minimally invasive anterolateral approach to the hip: risk to the superior gluteal nerve. Acta Orthop 78:86–89. https://doi.org/10.1080/17453670610013466
doi: 10.1080/17453670610013466
pubmed: 17453397
Khan T, Knowles D (2007) Damage to the Superior gluteal nerve during the direct lateral Approach to the hip. A cadaveric study. J Arthroplasty 22:1198–1200. https://doi.org/10.1016/j.arth.2006.11.013
doi: 10.1016/j.arth.2006.11.013
pubmed: 18078891
Eksioglu F, Uslu M, Gudemez E et al (2003) Reliability of the safe area for the superior gluteal nerve. Clin Orthop Relat Res 111–116. https://doi.org/10.1097/01.blo.0000068768.86536.7e
Kenanidis E, Paparoidamis G, Pegios VF et al (2022) Earlier functional recovery and discharge from hospital for THA patients operated on via direct superior compared to standard posterior approach: a retrospective frequency-matched case-control study. HIP Int. https://doi.org/10.1177/11207000221086506
doi: 10.1177/11207000221086506
pubmed: 35438023
Rasuli KJ, Gofton W (2015) Percutaneously assisted total hip (PATH) and supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty: learning curves and early outcomes. Annals Translational Med 3
Wang T, Shao L, Xu W et al (2019) Comparison of morphological changes of gluteus medius and abductor strength for total hip arthroplasty via posterior and modified direct lateral approaches. Int Orthop 43:2467–2475
doi: 10.1007/s00264-019-04331-z
pubmed: 31053885
Sershon RA, Tetreault MW, Della Valle CJ (2017) A prospective randomized trial of mini-incision posterior and 2-incision total hip arthroplasty: minimum 5-year follow-up. J Arthroplast 32:2462–2465
doi: 10.1016/j.arth.2017.03.038