Current overview of neurovascular structures in hip arthroplasty: anatomy, preoperative evaluation, approaches, and operative techniques to avoid complications.
Total hip arthroplasty is a common and relatively safe procedure with consistently good results. Despite its popularity and excellent results, THA is a major operation with several major neurovascular structures within reach of retractors, scalpel blades, drills, screws, and reamers. A thorough knowledge of their anatomic location and proximity to the operative field, along with a basic understanding of the principles of vascular surgery can help avoid potentially devastating consequences. Specifically, the surgeon should avoid placement of screws in the anterior-superior quadrant, be vigilant when placing retractors, and avoid excessive tension on the sciatic nerve.
Rue
John-Paul H
JP
Department of Orthopedic Surgery, The Johns Hopkins Medical Institutions Baltimore, MD, USA.
Inoue
Nozomu
N
Mont
Michael A
MA
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D006615:Hip / Q000098:blood supply* / Q000294:innervation*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care