The distance of the femoral neurovascular bundle from the hip joint: an intraoperative guide to reduce iatrogenic injury
Abstract Background Iatrogenic injury to the femoral neurovascular bundle is not uncommon during primary and revision total hip replacement (THR) and can result in permanent weakness, pain and poor function. Prevention of injury to these structures relies on a sound knowledge of their relationships...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13018-018-0847-5 |
| _version_ | 1828112909092257792 |
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| author | Cyrus R. Mehta Alex Constantinidis Moussa Farhat Mayuran Suthersan Edward Graham Andrew Kanawati |
| author_facet | Cyrus R. Mehta Alex Constantinidis Moussa Farhat Mayuran Suthersan Edward Graham Andrew Kanawati |
| author_sort | Cyrus R. Mehta |
| collection | DOAJ |
| description | Abstract Background Iatrogenic injury to the femoral neurovascular bundle is not uncommon during primary and revision total hip replacement (THR) and can result in permanent weakness, pain and poor function. Prevention of injury to these structures relies on a sound knowledge of their relationships to the hip joint. Methods We studied 115 consecutive hip magnetic resonance imaging (MRI) results in order to identify objective relationships between these structures and the hip joint that can be used intraoperatively. Results We determined that the shortest mean distances of the femoral nerve, artery and vein from the hip joint are 23.62 (standard deviation, SD = 5.44), 19.62 (SD = 4.17) and 17.47 (SD = 4.41) mm, respectively. The femoral nerve was lateral to the hip joint in 30 (55.5%) left- and 37 (60.7%) right-sided hip joints. The femoral artery was located medial to the hip joint in 28 (51.9%) left- and 34 (55.7%) right-sided hips. The femoral vein was medial to the hip joint in 52 (96.3%) left- and 58 (95.1%) right-sided hips. Conclusion We have identified objective relationships between the hip joint and femoral neurovascular bundle that can be used with ease intraoperatively during THR. Our data show that patients with a low body weight and the elderly may be at a higher risk of iatrogenic injury due to increased proximity of the neurovascular structures to the hip. Application of this knowledge may serve to reduce the risk of iatrogenic injury to these structures and thereby improve patient satisfaction and outcomes. |
| first_indexed | 2024-04-11T11:57:45Z |
| format | Article |
| id | doaj.art-ba19ab13ce8840d8ad661065990f2bc1 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T11:57:45Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-ba19ab13ce8840d8ad661065990f2bc12022-12-22T04:25:05ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2018-06-011311710.1186/s13018-018-0847-5The distance of the femoral neurovascular bundle from the hip joint: an intraoperative guide to reduce iatrogenic injuryCyrus R. Mehta0Alex Constantinidis1Moussa Farhat2Mayuran Suthersan3Edward Graham4Andrew Kanawati5Westmead HospitalWestmead HospitalWestmead HospitalWestmead HospitalWestmead HospitalWestmead HospitalAbstract Background Iatrogenic injury to the femoral neurovascular bundle is not uncommon during primary and revision total hip replacement (THR) and can result in permanent weakness, pain and poor function. Prevention of injury to these structures relies on a sound knowledge of their relationships to the hip joint. Methods We studied 115 consecutive hip magnetic resonance imaging (MRI) results in order to identify objective relationships between these structures and the hip joint that can be used intraoperatively. Results We determined that the shortest mean distances of the femoral nerve, artery and vein from the hip joint are 23.62 (standard deviation, SD = 5.44), 19.62 (SD = 4.17) and 17.47 (SD = 4.41) mm, respectively. The femoral nerve was lateral to the hip joint in 30 (55.5%) left- and 37 (60.7%) right-sided hip joints. The femoral artery was located medial to the hip joint in 28 (51.9%) left- and 34 (55.7%) right-sided hips. The femoral vein was medial to the hip joint in 52 (96.3%) left- and 58 (95.1%) right-sided hips. Conclusion We have identified objective relationships between the hip joint and femoral neurovascular bundle that can be used with ease intraoperatively during THR. Our data show that patients with a low body weight and the elderly may be at a higher risk of iatrogenic injury due to increased proximity of the neurovascular structures to the hip. Application of this knowledge may serve to reduce the risk of iatrogenic injury to these structures and thereby improve patient satisfaction and outcomes.http://link.springer.com/article/10.1186/s13018-018-0847-5Total hip arthroplastyIatrogenic injuryFemoral neurovascular structures |
| spellingShingle | Cyrus R. Mehta Alex Constantinidis Moussa Farhat Mayuran Suthersan Edward Graham Andrew Kanawati The distance of the femoral neurovascular bundle from the hip joint: an intraoperative guide to reduce iatrogenic injury Journal of Orthopaedic Surgery and Research Total hip arthroplasty Iatrogenic injury Femoral neurovascular structures |
| title | The distance of the femoral neurovascular bundle from the hip joint: an intraoperative guide to reduce iatrogenic injury |
| title_full | The distance of the femoral neurovascular bundle from the hip joint: an intraoperative guide to reduce iatrogenic injury |
| title_fullStr | The distance of the femoral neurovascular bundle from the hip joint: an intraoperative guide to reduce iatrogenic injury |
| title_full_unstemmed | The distance of the femoral neurovascular bundle from the hip joint: an intraoperative guide to reduce iatrogenic injury |
| title_short | The distance of the femoral neurovascular bundle from the hip joint: an intraoperative guide to reduce iatrogenic injury |
| title_sort | distance of the femoral neurovascular bundle from the hip joint an intraoperative guide to reduce iatrogenic injury |
| topic | Total hip arthroplasty Iatrogenic injury Femoral neurovascular structures |
| url | http://link.springer.com/article/10.1186/s13018-018-0847-5 |
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