Abstract:Objective To investigate the causes of nerve palsy complications in minimally invasive total hip arthroplasty via a direct anterior approach and its prevention strategy. Methods A computer-based search was conducted in PubMed and CNKI databases for literatures related to minimally invasive total hip arthroplasty via a direct anterior approach from January 2005 to November 2016 with the key words “direct anterior approach”, “lateral femoral cutaneous nerve” in English and “直接前侧入路”, “股外侧皮神经” in Chinese. As a result, 28 articles were carefully reviewed. Analysis was conducted for the anatomical features of direct anterior approach, Hueter interval and lateral femoral cutaneous nerve as well as the prevention strategies for never injury based on the selected articles. Results Lateral femoral cutaneous nerve injury is one of common complications of direct anterior approach for total hip replacement, and the incidence is between 0.9%-3.4%. Total hip arthroplasty through the Hueter interval is the fittest procedure, which meet the standard of minimally invasive surgery. Unfortunately, lateral femoral cutaneous nerve is constantly injuried during splitting subcutaneous soft tissue when skin incision is carried. To alleviate the injury to the lateral femoral cutaneous nerve, surgeons can choose suitable incision location, make surgical procedures exquisite, pull the retractor in a longitudinal direction, and locate the intermuscular septum perforating branches. Conclusions Compared with traditional total hip arthroplasty, direct anterior approach has less soft tissue injury theoretically, and, meanwhile, there are prevention strategies to alleviate lateral femoral cutaneous nerve injuries which occur in this surgical procedures.
高辉,叶山山,何春耒,陈震东,刘承鸿. 直接前侧入路微创全髋关节置换术中股外侧皮神经损伤的研究进展[J]. 中华解剖与临床杂志, 2017, 22(3): 248-251.
Gao hui, Ye Shanshan, He Chunlei, Chen Zhengdong, Liu Chenghong. Research progress of the lateral femoral cutaneous nerve injury during total hip arthroplasty with a direct anterior approach. Chinese Journal of Anatomy and Clinics, 2017, 22(3): 248-251.
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