What is the anatomy of the hip relevant to hip arthroscopy?

Updated: Apr 10, 2019
  • Author: Bart Eastwood, DO; Chief Editor: Dinesh Patel, MD, FACS  more...
  • Print
Answer

Proper portal placement for hip arthroscopy depends on an understanding of the anatomy about the hip. Anterior and medial structures to be taken into account include the femoral artery, the femoral vein, and the femoral nerve (see the images below); typically, these are 3.2 cm from the anterior portal. [14] Posteriorly, the sciatic nerve lies 2.9 cm from the posterior portal; it may be at risk if the portal drifts too far that direction. Superiorly, the superior gluteal nerve and artery lie 4.4 cm from the anterior and posterior lateral portals.

Frontal view of hip area, showing femoral vein, ne Frontal view of hip area, showing femoral vein, nerve, and artery, along with tensor fasciae latae. Courtesy of Wikimedia Commons.
Cross-section at hip, showing locations of femoral Cross-section at hip, showing locations of femoral nerve, artery, and vein. Courtesy of Wikimedia Commons.

More anteriorly, the lateral femoral cutaneous nerve (LFCN; see the images below), along with its terminal branches, lies closer to a portal than any other significant neurovascular structure and is the most commonly affected nerve in terms of complications. A study by Byrd et al found that the anterior portal came within 0.3 cm of LFCN branches. [14, 15]

Location of lateral femoral cutaneous nerve. Location of lateral femoral cutaneous nerve.
Location of femoral neurovascular structures and l Location of femoral neurovascular structures and lateral femoral cutaneous nerve in relation to acetabulum. Courtesy of Wikimedia Commons.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!