A systematic review and meta-analysis of the hip capsule innervation and its clinical implications

Joanna Tomlinson, Benjamin Ondruschka, Torsten Prietzel, Johann Zwirner, Niels Hammer

Research output: Contribution to journalArticle (Academic Journal)peer-review

19 Citations (Scopus)
79 Downloads (Pure)

Abstract

Detailed understanding of the innervation of the hip capsule (HC) helps inform surgeons' and anaesthetists' clinical practice. Post-interventional pain following radiofrequency nerve ablation (RFA) and dislocation following total hip arthroplasty (THA) remain poorly understood, highlighting the need for more knowledge on the topic. This systematic review and meta-analysis focuses on gross anatomical studies investigating HC innervation. The main outcomes were defined as the prevalence, course, density and distribution of the nerves innervating the HC and changes according to demographic variables. HC innervation is highly variable; its primary nerve supply seems to be from the nerve to quadratus femoris and obturator nerve. Many articular branches originated from muscular branches of the lumbosacral plexus. It remains unclear whether demographic or anthropometric variables may help predict potential differences in HC innervation. Consequently, primary targets for RFA should be the anterior inferomedial aspect of the HC. For THA performed on non-risk patients, the posterior approach with capsular repair appears to be most appropriate with the lowest risk of articular nerve damage. Care should also be taken to avoid damaging vessels and muscles of the hip joint. Further investigation is required to form a coherent map of HC innervation, utilizing combined gross and histological investigation.

Original languageEnglish
Pages (from-to)5299
JournalScientific Reports
Volume11
Issue number1
DOIs
Publication statusPublished - 5 Mar 2021

Keywords

  • Arthroplasty, Replacement, Hip/adverse effects
  • Cadaver
  • Femoral Nerve/anatomy & histology
  • Hip Joint/anatomy & histology
  • Humans
  • Joint Capsule/anatomy & histology
  • Obturator Nerve/anatomy & histology
  • Pain, Postoperative/etiology
  • Radiofrequency Ablation/adverse effects
  • Sciatic Nerve/anatomy & histology

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