Neurovascular Structures at Risk During Anterolateral and Medial Arthroscopic Approaches of the Hip

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Omar Méndez-Aguirre; Rodolfo Morales-Avalos; Gustavo A. Compeán-Martínez; Abraham G. Espinosa-Uribe; Félix Vílchez-Cavazos; María del Carmen Theriot-Giron; Alejandro Quiroga-Garza; Oscar de la Garza-Castro; Katia Guzmán Avilán; Santos Guzmán-López & Rodrigo E. Elizondo-Omaña


To describe the safety areas for placement of 5 anterolateral portals (anterior, anterior lateral, posterior lateral, proximal anterior medial and distal anterior medial portals) and 3 recently described medial portals (anterior medial, posterior medial and distal posterior medial portals) to provide topographical description of the safety of each. A descriptive, observational and cross- sectional study in which femoral triangle dissection was performed in 12 hips. 5 lateral portals and the 3 medial portals were placed. Clinically relevant neurovascular structures associated with each portal, were identified measured and documented. The lateral portal with the highest risk of injury to a nearby neurovascular structure was the anterior portal, the most adjacent to the femoral cutaneous nerve, 1.42 cm (±0.85) lateral to the portal. In the medial portals, the anterior medial portal has the narrowest margin in relation to the femoral artery, 2.14 cm (±0.35) lateral to the portal and medial to the obturator nerve by 0.87 cm (±0.62). The lateral portals have a higher safety margin; the portal with the most proximity to a neurovascular structure is the anterior portal, associated laterally with the femoral cutaneous nerve, presenting a higher risk of injury. Medial portals have a higher risk of injuring the femoral neurovascular bundle as well as the obturator nerve.

KEY WORDS: Anatomy; Arthroscopy; Hip; Portal.

How to cite this article

MÉNDEZ-AGUIRRE, O.; MORALES-AVALOS, R.; COMPEÁN-MARTÍNEZ, G. A.; ESPINOSA-URIBE, A. G.; VÍLCHEZ- CAVAZOS, F.; THERIOT-GIRON, M. C.; QUIROGA-GARZA, A.; DE LA GARZA-CASTRO, O.; GUZMÁN-AVILÁN, K.; GUZMÁN-LÓPEZ, S. & ELIZONDO-OMAÑA, R. E. Neurovascular structures at risk during anterolateral and medial arthroscopic approaches of the hip. Int. J. Morphol., 34(2):752-758, 2016.