Results of Localization of the lateral cutaneous nerve of the thigh before performing the anterior portal of hip arthroscopy

Introduction
Palsy of the lateral cutaneous nerve of the thigh is one of the neurological complications recognized to occur after performing the anterior portal of hip arthroscopy which is also associated with the possibility of various complications, being near the neurovascular structures is one of the reasons for some of these complications. The discomfort caused by palsy of the lateral cutaneous nerve of the thigh can cause the patient’s dissatisfaction and suffering which in some severe cases can outweigh the benefit from the arthroscopic treatment.


Aim
The primary objective was to assess the effect of ultrasound mapping of the lateral cutaneous nerve of the thigh in reducing the risk of its injury while performing the anterior portal of hip arthroscopy, the secondary objective was to assess the effect of getting the anterior portal medially as safely as possible, so that to be in direct access to the anterior part of the labrum, on traction time and subsequently traction related complications, of which the pudendal nerve injury is the most worrying.


Methods
The study included 39 patients undergoing hip arthroscopy for anterior labral repair and femoral osteoplasty and/or acetabuloplasty between March 2020 and December 2022.


Results
The traction time averaged 57.3 min (range 40–85 min; SD 11.3). Two (5.1%) patients suffered partial lateral cutaneous nerve of the thigh palsy. Postoperatively seven (17.9%) patients had partial pudendal nerve palsy in the form of numbness at the perineum which recovered within 7.6 weeks (range 5–10 weeks; SD 1.7), one (2.6%) patient suffered complete palsy in the form of numbness and temporary impotence which recovered completely after 3 months.


Conclusion
The present research demonstrates the safety and potential advantages of employing ultrasound to locate the lateral cutaneous nerve of the thigh, which could also decrease the time spent on traction and its related complications.