Topographic anatomical study of the sciatic nerve relationship to the posterior portal in hip arthroscopy.
OBJECTIVE
To evaluate the anatomic topographic relation between the sciatic nerve in relation to the piriform muscle and the posterior portal for the establishment of hip arthroscopy.


METHODS
We dissected 40 hips of 20 corpses of adult Brazilians, 17 male and three female, six black, six brown and eight white. We studied the anatomical relationship between the sciatic nerve and the piriform muscle with their variations and the distance between the lateral edge of the sciatic nerve and the posterior portal used in hip arthroscopy. We then classified the anatomical alterations found in the path of the sciatic nerve on the piriform muscle.


RESULTS
Seventeen corpses had bilateral relationship between the sciatic nerve and the piriform muscle, i.e., type A. We found the following anatomical variations: 12.5% of variant type B; and an average distance between the sciatic nerve and the portal for arthroscopy of 2.98cm. One body had type B anatomical variation on the left hip and type A on the right.


CONCLUSIONS
the making of the posterior arthroscopic portal to the hip joint must be done with careful marking of the trochanter massive; should there be difficult to find it, a small surgical access is recommended. The access point to the portal should not exceed two centimeters towards the posterior superior aspect of the greater trochanter, and must be made with the limb in internal rotation of 15 degrees.
Gafrée Guinle University Hospital, Rio de Janeiro, Rio de Janeiro State, Brazil.
Berliet Assad
BA
Gomes
Department of General and Specialized Surgery, Federal University of the State of Rio de Janeiro.
Max Rogério Freitas
MR
Ramos
Department of Surgery, Gafrée Guinle University Hospital.
Rossano Kepler Alvim
RK
Fiorelli
Gafrée Guinle University Hospital.
Camila Rodrigues de
CR
Almeida
Department of General and Specialized Surgery, Federal University of the State of Rio de Janeiro.
Stênio Karlos Alvim
SK
Fiorelli
D000328:Adult; D001182:Arthroscopy; D002081:Buttocks / Q000033:anatomy & histology; D002102:Cadaver; D005260:Female; D006621:Hip Joint; D006801:Humans; D008297:Male; D012584:Sciatic Nerve / Q000033:anatomy & histology*