Abstract
BackgroundThe key for successful delivery in minimally-invasive hip replacement lies in the exact knowledge about the surgical anatomy. The minimally-invasive direct anterior approach to the hip joint makes it necessary to clearly identify the tensor fasciae latae muscle in order to enter the Hueter interval without damaging the lateral femoral cutaneous nerve. However, due to the inherently restricted overview in minimally-invasive surgery, this can be difficult even for experienced surgeons.Methods and Surgical TechniqueIn this technical note, we demonstrate for the first time how to use the tensor fasciae latae perforator as anatomical landmark to reliably identify the tensor fasciae latae muscle in orthopaedic surgery. Such perforators are used for flaps in plastic surgery as they are constant and can be found at the lateral third of the tensor fasciae latae muscle in a direct line from the anterior superior iliac spine.ConclusionAs demonstrated in this article, a simple knowledge transfer between surgical disciplines can minimize the complication rate associated with minimally-invasive hip replacement.
Highlights
The key for successful delivery in minimally-invasive hip replacement lies in the exact knowledge about the surgical anatomy
As demonstrated in this article, a simple knowledge transfer between surgical disciplines can minimize the complication rate associated with minimally-invasive hip replacement
Since multiple other authors developed minimally-invasive techniques and continued to use those in various modifications to treat a plethora of different disorders around the hip joint [7,8,9,10,11]. All those methods have in common that they utilise the muscular interval between the sartorius and the tensor fasciae latae muscle, which is known as the Hueter interval. Using this interval poses the risk of damaging the lateral femoral cutaneous nerve as its Rudert et al BMC Musculoskeletal Disorders (2016) 17:57 elegant technique where they incise the superficial thigh fascia as laterally as possible over the belly of the tensor fasciae latae muscle followed by blunt dissection between the muscle and the superficial fascia thereby entering the Hueter interval [13,14,15] (Fig. 1)
Summary
Technique: In this technical note, we demonstrate for the first time how to use the tensor fasciae latae perforator as anatomical landmark to reliably identify the tensor fasciae latae muscle in orthopaedic surgery. Such perforators are used for flaps in plastic surgery as they are constant and can be found at the lateral third of the tensor fasciae latae muscle in a direct line from the anterior superior iliac spine
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