The distance between the femoral nerve and anterior acetabulum is significantly shorter in hip osteoarthritis than in non-osteoarthritis hip
Abstract Background The appropriate position of retractors to minimize the risk of femoral nerve palsy remains uncertain. The purpose of this imaging study was to evaluate the distance between the femoral nerve (FN) and anterior acetabulum (AA) in hip osteoarthritis (OA). Methods Forty-one patients...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-05-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-021-04295-5 |
| _version_ | 1818676316959932416 |
|---|---|
| author | Kensuke Yoshino Shigeo Hagiwara Junichi Nakamura Takuro Horikoshi Hajime Yokota Kenji Shimokawa Koji Matsumoto Yuki Shiko Yohei Kawasaki Seiji Ohtori |
| author_facet | Kensuke Yoshino Shigeo Hagiwara Junichi Nakamura Takuro Horikoshi Hajime Yokota Kenji Shimokawa Koji Matsumoto Yuki Shiko Yohei Kawasaki Seiji Ohtori |
| author_sort | Kensuke Yoshino |
| collection | DOAJ |
| description | Abstract Background The appropriate position of retractors to minimize the risk of femoral nerve palsy remains uncertain. The purpose of this imaging study was to evaluate the distance between the femoral nerve (FN) and anterior acetabulum (AA) in hip osteoarthritis (OA). Methods Forty-one patients with unilateral hip OA underwent magnetic resonance imaging. Three measurement levels were defined and the minimum distance between the femoral nerve (FN) margin and anterior acetabulum (AA) rim was measured on axial T1-weighted images on the OA and normal sides at each level, with reference to an advanced neurography view. The cross-sectional area (CSA) of the iliopsoas muscle was also measured at each level bilaterally by three observers. Distances and CSAs were compared between the OA and normal side. Multiple regression analysis was performed to identify variables associated with the distance in OA. Results The mean minimum FN to AA distances in OA were 19.4 mm at the top of the anterior inferior iliac spine (AIIS), 24.3 mm at the bottom of the AIIS, and 21.0 mm at the tip of the greater trochanter. These distances were significantly shorter than in normal hips at the top and bottom of the AIIS, with mean differences of 1.6 and 5.8 mm, respectively (p = 0.012, p < 0.001). CSAs of the iliopsoas in OA were significantly smaller at all levels (all p < 0.001), with reductions of 10.5 to 17.9%. The CSA of the iliopsoas at the bottom of the AIIS was associated with the FN to AA distance at the same level (p = 0.026). Interobserver reliabilities for measurements were very good to perfect (intraclass correlation coefficients 0.897 to 0.966). Conclusions To minimize the risk of femoral nerve palsy, surgeons should consider the change of the femoral nerve to anterior acetabulum distance in osteoarthritic hip surgery. |
| first_indexed | 2024-12-17T08:41:33Z |
| format | Article |
| id | doaj.art-da69b84e5e5b415b9c55fe305c69b9fd |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-17T08:41:33Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-da69b84e5e5b415b9c55fe305c69b9fd2022-12-21T21:56:19ZengBMCBMC Musculoskeletal Disorders1471-24742021-05-012211810.1186/s12891-021-04295-5The distance between the femoral nerve and anterior acetabulum is significantly shorter in hip osteoarthritis than in non-osteoarthritis hipKensuke Yoshino0Shigeo Hagiwara1Junichi Nakamura2Takuro Horikoshi3Hajime Yokota4Kenji Shimokawa5Koji Matsumoto6Yuki Shiko7Yohei Kawasaki8Seiji Ohtori9Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba UniversityDiagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba UniversityDiagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba UniversityDiagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba UniversityDiagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba UniversityBiostatistics Section, Clinical Research Center, Chiba University HospitalBiostatistics Section, Clinical Research Center, Chiba University HospitalDepartment of Orthopaedic Surgery, Graduate School of Medicine, Chiba UniversityAbstract Background The appropriate position of retractors to minimize the risk of femoral nerve palsy remains uncertain. The purpose of this imaging study was to evaluate the distance between the femoral nerve (FN) and anterior acetabulum (AA) in hip osteoarthritis (OA). Methods Forty-one patients with unilateral hip OA underwent magnetic resonance imaging. Three measurement levels were defined and the minimum distance between the femoral nerve (FN) margin and anterior acetabulum (AA) rim was measured on axial T1-weighted images on the OA and normal sides at each level, with reference to an advanced neurography view. The cross-sectional area (CSA) of the iliopsoas muscle was also measured at each level bilaterally by three observers. Distances and CSAs were compared between the OA and normal side. Multiple regression analysis was performed to identify variables associated with the distance in OA. Results The mean minimum FN to AA distances in OA were 19.4 mm at the top of the anterior inferior iliac spine (AIIS), 24.3 mm at the bottom of the AIIS, and 21.0 mm at the tip of the greater trochanter. These distances were significantly shorter than in normal hips at the top and bottom of the AIIS, with mean differences of 1.6 and 5.8 mm, respectively (p = 0.012, p < 0.001). CSAs of the iliopsoas in OA were significantly smaller at all levels (all p < 0.001), with reductions of 10.5 to 17.9%. The CSA of the iliopsoas at the bottom of the AIIS was associated with the FN to AA distance at the same level (p = 0.026). Interobserver reliabilities for measurements were very good to perfect (intraclass correlation coefficients 0.897 to 0.966). Conclusions To minimize the risk of femoral nerve palsy, surgeons should consider the change of the femoral nerve to anterior acetabulum distance in osteoarthritic hip surgery.https://doi.org/10.1186/s12891-021-04295-5Femoral nerveAcetabulumHip osteoarthritisIliopsoas muscleMagnetic resonance imaging |
| spellingShingle | Kensuke Yoshino Shigeo Hagiwara Junichi Nakamura Takuro Horikoshi Hajime Yokota Kenji Shimokawa Koji Matsumoto Yuki Shiko Yohei Kawasaki Seiji Ohtori The distance between the femoral nerve and anterior acetabulum is significantly shorter in hip osteoarthritis than in non-osteoarthritis hip BMC Musculoskeletal Disorders Femoral nerve Acetabulum Hip osteoarthritis Iliopsoas muscle Magnetic resonance imaging |
| title | The distance between the femoral nerve and anterior acetabulum is significantly shorter in hip osteoarthritis than in non-osteoarthritis hip |
| title_full | The distance between the femoral nerve and anterior acetabulum is significantly shorter in hip osteoarthritis than in non-osteoarthritis hip |
| title_fullStr | The distance between the femoral nerve and anterior acetabulum is significantly shorter in hip osteoarthritis than in non-osteoarthritis hip |
| title_full_unstemmed | The distance between the femoral nerve and anterior acetabulum is significantly shorter in hip osteoarthritis than in non-osteoarthritis hip |
| title_short | The distance between the femoral nerve and anterior acetabulum is significantly shorter in hip osteoarthritis than in non-osteoarthritis hip |
| title_sort | distance between the femoral nerve and anterior acetabulum is significantly shorter in hip osteoarthritis than in non osteoarthritis hip |
| topic | Femoral nerve Acetabulum Hip osteoarthritis Iliopsoas muscle Magnetic resonance imaging |
| url | https://doi.org/10.1186/s12891-021-04295-5 |
| work_keys_str_mv | AT kensukeyoshino thedistancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT shigeohagiwara thedistancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT junichinakamura thedistancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT takurohorikoshi thedistancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT hajimeyokota thedistancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT kenjishimokawa thedistancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT kojimatsumoto thedistancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT yukishiko thedistancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT yoheikawasaki thedistancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT seijiohtori thedistancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT kensukeyoshino distancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT shigeohagiwara distancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT junichinakamura distancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT takurohorikoshi distancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT hajimeyokota distancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT kenjishimokawa distancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT kojimatsumoto distancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT yukishiko distancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT yoheikawasaki distancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship AT seijiohtori distancebetweenthefemoralnerveandanterioracetabulumissignificantlyshorterinhiposteoarthritisthaninnonosteoarthritiship |