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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
https://doi.org/10.1016/j.arthro.2013.12.012

Purpose

To measure the distances between key neurovascular structures and commonly used hip arthroscopy landmarks and assess variation by demographic factors.

Methods

MRI imaging was used to analyze neurovascular anatomy in 100 patients. Distances to the lateral femoral cutaneous nerve (LFCN), femoral nerve, sciatic nerve, and femoral artery were measured and compared by BMI, weight, and race.

Key Findings

  • The LFCN was closest to standard arthroscopy portals and the most at risk.
  • Significant demographic variability was found in structure proximity.
  • Distance variations were associated with BMI, weight, and race.
  • LFCN showed the greatest variability and proximity to surgical landmarks.

Conclusion

There is significant variability in neurovascular anatomy relevant to hip arthroscopy. LFCN is most at risk during portal placement.

What This Means for Patients

Surgeons must consider individual patient anatomy, especially body size and race, to minimize nerve injury during hip arthroscopy.