Anatomical study of hip arthroscopy portals and its relationship with neurovascular structures

Abstract

Summary: The hip is a deep joint, surrounded by several muscles, nerves and major vessels, all of them in risk of damage during any surgical procedure, therefore hip arthroscopy is not the exception. The aim of this study was to describe the relationship of the hip arthroscopy portals with neurovascular structures.
Materials & Methods: Four standard arthroscopic portals were made in twelve hips from six fresh cadaveric specimens with previous skeletal traction, using standard fluoroscopic control. Specimens were dissected and the distance from portals to the neurovascular structures near them was measured.
Results: The closest structure to the anterior portal was the femorocutaneous nerve (average: 12,02 mm). To the distal accessory portal, the nearest one was the ascending branch of the lateral circumflex artery (average: 10,64 mm). The superior gluteal nerve was the structure at risk with the anterolateral portal at an average distance of 35,41 mm. The sciatic nerve was the structure at risk with the posterolateral portal, the average distance between them was 15,98 mm. None of the portals got in contact with any of the evaluated noble structures or damaged them.
Discussion: This study shows that standard placement of hip arthroscopy portals is safe in hispanic population and the measures that we obtained are similar to that reported in other studies in North American and European population.
Evidence Level: IV.