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Do Acetabular Buttress Augment Pose Risk to the Superior Gluteal Nerve? A Cadaveric Study
Austin A Cole1, Parker R Zimmerman2, Michael S Sridhar1
1Department of Orthopedic Surgery, Prisma Health - Upstate, Greenville, SC, USA.
Arthroplasty Today
|February 1, 2021
Summary
Acetabular buttress augment placement risks injury to the superior gluteal nerve. This study measured the nerve
Area of Science:
- Orthopedic surgery
- Anatomy
- Biomedical engineering
Background:
- Acetabular defects in total joint reconstruction pose surgical challenges.
- Posterosuperior acetabular buttress augments are used for severe defects.
- The superior gluteal nerve is vulnerable during augment placement, potentially impacting hip stability and gait.
Purpose of the Study:
- To determine the anatomical relationship between the acetabular rim and the superior gluteal nerve.
- To assess the risk to the superior gluteal nerve during the placement of posterosuperior acetabular buttress augments.
Main Methods:
- Examination of ten adult cadaver specimens.
- Measurement of the distance between the superior gluteal nerve and the posterosuperior acetabular rim using a reproducible technique.
- Measurements were taken 20 mm lateral to the greater sciatic notch.
Main Results:
- The average distance between the posterosuperior acetabular rim and the superior gluteal nerve was 52 mm (range: 48-60 mm).
Conclusions:
- Acetabular augments up to 68 mm may pose a substantial risk to the superior gluteal nerve.
- Surgeons must exercise caution during dissection and intraoperative placement of augments.
- Optimizing prosthetic hip stability is crucial to mitigate dislocation risk secondary to nerve injury.
