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Updated: Aug 29, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Current overview of neurovascular structures in hip arthroplasty: anatomy, preoperative evaluation, approaches, and
John-Paul H Rue1, Nozomu Inoue, Michael A Mont
1Department of Orthopedic Surgery, The Johns Hopkins Medical Institutions Baltimore, MD, USA.
Abstract:
Total hip arthroplasty is a common and relatively safe procedure with consistently good results. Despite its popularity and excellent results, THA is a major operation with several major neurovascular structures within reach of retractors, scalpel blades, drills, screws, and reamers. A thorough knowledge of their anatomic location and proximity to the operative field, along with a basic understanding of the principles of vascular surgery can help avoid potentially devastating consequences. Specifically, the surgeon should avoid placement of screws in the anterior-superior quadrant, be vigilant when placing retractors, and avoid excessive tension on the sciatic nerve.
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