ArticleBMC musculoskeletal disorders2023
Leg position effects on the femoral neurovascular bundle location during a direct anterior approach total hip arthroplasty: a radiographic study.
Article in BMC musculoskeletal disorders, 2023. 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, 2 citations in OpenAlex.
- Intraoperative six-axis loads during direct anterior approach total hip arthroplasty using a leg positioner: quantitative patterns across manoeuvres.International orthopaedics · 2026Article
- Early CTA Diagnosis of Hemodynamically Occult External Iliac Artery Injury After Direct Anterior Total Hip Arthroplasty Treated with Covered Stent-Graft Repair: A Case Report.Diagnostics (Basel, Switzerland) · 2026Article
- A Nerve Injury After Total Hip Arthroplasty from Etiology to Treatment: A Narrative Review.Journal of clinical medicine · 2026Review
- Changes in the anatomical positions of the femoral nerve and artery in the lateral and supine positions: a multicenter retrospective study.Archives of orthopaedic and trauma surgery · 2025Article
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundFemoral neurovascular injury is a serious complication in a direct anterior approach (DAA) total hip arthroplasty. However, dynamic neurovascular bundle location changes during the approach were not examined. Thus, this study aimed to analyze the effects of leg position on the femoral neurovascular bundle location using magnetic resonance imaging (MRI).
methodsThis study scanned 30 healthy volunteers (15 males and 15 females) with 3.0T MRI in a supine and 30-degree hip extension position with the left leg in a neutral rotation position and the right leg in a 45-degree external extension position. The minimum distance from the edge of the anterior acetabulum to the femoral nerve (dFN), artery, and vein were measured on axial T1-weighted images at the hip center level, as well as the angle to the horizontal line of the femoral nerve (aFN), artery (aFA), and vein from the anterior acetabulum.
resultsThe dFN in the supine position with external rotation was significantly larger than supine with neutral and extension with external rotation position (20.7, 19.5, and 19.0; p = 0.031 and 0.012, respectively). The aFA in supine with external rotation was significantly larger than in other postures (52.4°, 34.2°, and 36.2°, p < 0.001, respectively). The aFV in supine with external rotation was significantly larger than in supine with a neutral position (52.3° versus 47.7°, p = 0.037). The aFN in supine and external rotation was significantly larger than other postures (54.6, 38.2, and 33.0, p < 0.001, respectively).
conclusionsThis radiographic study revealed that the leg position affected the neurovascular bundle location. These movements can be the risk of direct neurovascular injury or traction.
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