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What Is the Risk Posed to the Lateral Femoral Cutaneous Nerve During the Use of the Anterior Portal of Supine Hip Arthroscopy and the Minimally Invasive Anterior Approach for Total Hip Arthroplasty?

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cam.issuedOnline2018-02-23
dc.contributor.authorBartlett, Jonathan D
dc.contributor.authorLawrence, John E
dc.contributor.authorKhanduja, Vikas
dc.contributor.orcidKhanduja, Vikas [0000-0001-9454-3978]
dc.date.accessioned2018-09-07T09:29:25Z
dc.date.available2018-09-07T09:29:25Z
dc.date.issued2018-06
dc.description.abstractPURPOSE: To determine: (1) What is the proximity of the lateral femoral cutaneous nerve (LFCN) to the anterior portal (AP) used in supine hip arthroscopy? (2) What is the proximity of the LCFN to the incision in the minimally invasive anterior approach (MIAA) for total hip arthroplasty? (3) What effect does lateralizing the AP have on the likelihood of nerve injury? (4) What branching patterns are observable in the LFCN? METHODS: Forty-five hemipelves were dissected. The LFCN was identified and its path dissected. The positions of the nerve in relation to the AP and the MIAA incision were measured. RESULTS: The AP intersected with 38% of nerves. In the remainder, the LFCN was located 5.7 ± 4.5 mm from the portal's edge. In addition, 44% of nerves crossed the incision of the MIAA. Of those that did not, the average minimum distance from the incision was 14.4 ± 7.0 mm. We found a significant reduction in risk if the AP is moved medially by 5 mm or laterally by 15 mm (P = .0054 and P = .0002). The LFCN showed considerable variation with 4 branching variants. CONCLUSIONS: These results show that the LFCN is at high risk during supine hip arthroscopy and the MIAA, emphasizing the need for meticulous dissection. We suggest that relocation of the AP 5 mm medially or 15 mm laterally will reduce the risk to the LFCN. CLINICAL RELEVANCE: These findings should aid surgeons in minimizing the risk to the LCFN during hip arthroscopy and the minimally invasive anterior approach to the hip.
dc.identifier.doi10.17863/CAM.23954
dc.identifier.eissn1526-3231
dc.identifier.issn0749-8063
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/279691
dc.languageeng
dc.language.isoeng
dc.publisherElsevier
dc.publisher.urlhttps://www.sciencedirect.com/science/article/pii/S0749806318300367?via=ihub#!
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectArthroplasty, Replacement, Hip
dc.subjectArthroscopy
dc.subjectCadaver
dc.subjectFemale
dc.subjectFemoral Nerve
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPostoperative Complications
dc.subjectRisk Factors
dc.subjectThigh
dc.titleWhat Is the Risk Posed to the Lateral Femoral Cutaneous Nerve During the Use of the Anterior Portal of Supine Hip Arthroscopy and the Minimally Invasive Anterior Approach for Total Hip Arthroplasty?
dc.typeArticle
dcterms.dateAccepted2018-01-03
prism.endingPage1840
prism.issueIdentifier6
prism.publicationDate2018
prism.publicationNameArthroscopy
prism.startingPage1833
prism.volume34
rioxxterms.licenseref.startdate2018-06
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1016/j.arthro.2018.01.012

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