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

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...

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Autores principales:	Joanna Tomlinson, Benjamin Ondruschka, Torsten Prietzel, Johann Zwirner, Niels Hammer
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ee36077a9f254bbbbc21940ebd45e8b7
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spelling	oai:doaj.org-article:ee36077a9f254bbbbc21940ebd45e8b72021-12-02T13:19:29ZA systematic review and meta-analysis of the hip capsule innervation and its clinical implications10.1038/s41598-021-84345-z2045-2322https://doaj.org/article/ee36077a9f254bbbbc21940ebd45e8b72021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84345-zhttps://doaj.org/toc/2045-2322Abstract 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.Joanna TomlinsonBenjamin OndruschkaTorsten PrietzelJohann ZwirnerNiels HammerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joanna Tomlinson Benjamin Ondruschka Torsten Prietzel Johann Zwirner Niels Hammer A systematic review and meta-analysis of the hip capsule innervation and its clinical implications
description	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.
format	article
author	Joanna Tomlinson Benjamin Ondruschka Torsten Prietzel Johann Zwirner Niels Hammer
author_facet	Joanna Tomlinson Benjamin Ondruschka Torsten Prietzel Johann Zwirner Niels Hammer
author_sort	Joanna Tomlinson
title	A systematic review and meta-analysis of the hip capsule innervation and its clinical implications
title_short	A systematic review and meta-analysis of the hip capsule innervation and its clinical implications
title_full	A systematic review and meta-analysis of the hip capsule innervation and its clinical implications
title_fullStr	A systematic review and meta-analysis of the hip capsule innervation and its clinical implications
title_full_unstemmed	A systematic review and meta-analysis of the hip capsule innervation and its clinical implications
title_sort	systematic review and meta-analysis of the hip capsule innervation and its clinical implications
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ee36077a9f254bbbbc21940ebd45e8b7
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A systematic review and meta-analysis of the hip capsule innervation and its clinical implications

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