The Anatomical Course of the Superior Gluteal Nerve With Regard to the Direct Anterior Approach for Primary and Revision Total Hip Arthroplasty

BackgroundDuring primary and revision total hip arthroplasty (THA) lesions of the superior gluteal nerve (SGN) can substantially compromise patient outcome. For direct anterior approach (DAA) its proximal extensions, especially muscular branch entering tensor fasciae latae (TFL) muscle is at risk. SGN result in fatty atrophy functional loss TFL. Therefore, course branching pattern were examined related to DAA extension. The aim study describe safe danger zones for with regard extensions.MethodsTwenty-five formalin-fixed cadavers 48 hemipelves dissected. course, distribution, inserting into TFL investigated help anatomical landmarks like greater trochanter iliac tubercle.ResultsIn 72.9% specimens passed sciatic foramen piriformis one main trunk. supplying divided from 89.6% level foramen. Before showed a variable interval between gluteus medius minimus. A zone was found fourth skin incision.ConclusionSpecial care instrument placement should be taken during DAA. When extending proximally manipulations proximal, caudal surgical window performed utmost care.