ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2020
Anterior acetabular retractors and the femoral neurovascular bundle in anterior total hip arthroplasty: a cadaveric study.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 11 citations in OpenAlex.
- Comparison of quadricep motor evoked potentials between different surgical positions during total hip arthroplasty.Journal of clinical monitoring and computing · 2025Article
- Optimizing total hip arthroplasty: the gripper table mounted system for enhanced soft tissue preservation and postoperative outcomes.Archives of orthopaedic and trauma surgery · 2024Article
- Should we be concerned when the anterior approach to the hip goes accidentally medial? A retrospective study.Arthroplasty (London, England) · 2024Article
- Accuracy of augmented reality with computed tomography-based navigation in total hip arthroplasty.Journal of orthopaedic surgery and research · 2023Article
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Authors and funding
7 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe direct anterior approach for primary total hip arthroplasty (THA) has become increasingly popular in recent years. Nerve compression or traction with a retractor is a common cause of nerve injury in this approach. The purpose of this cadaveric study was to evaluate the anatomic relationship of the femoral neurovascular bundle to the anterior acetabular retractor during direct anterior approach THA.
methodsEleven fresh-frozen cadavers underwent a standard direct anterior THA, with placement of an anterior acetabular retractor in the usual fashion between the iliopsoas and acetabulum for visualization during acetabular preparation. Careful dissection of the femoral triangle was performed, and the distances from the anterior retractor tip to the femoral nerve, artery, and vein were recorded and analyzed as mean distance ± standard deviation.
resultsIn all 11 cadavers, the retractor tip was medial to the femoral nerve. The mean distance from retractor tip to femoral artery and vein was 5.9 mm (SD = 5.5, range 0-20) and 12.6 mm (SD 0.7, range 0-35), respectively.
conclusionsSurgeons should be aware of the proximity of the neurovascular structures in relation to the anterior acetabular retractor in the direct anterior approach, taking care to avoid perforating the iliopsoas muscle during retractor insertion and limit excessive traction to prevent nerve injury.
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