Reports estimate 2.5 million Americans have undergone total hip arthroplasty, the primary treatment for patients with degenerative hip joint disease, and are living with implants. It can significantly improve patients’ quality of life, and is one of the most commonly performed operations in the United States. However, approximately 0.6 - 7.6%, experience femoral nerve palsy as a complication of the procedure and 0.1 - 0.2% experience vascular damage. These complications in turn often lead to patient readmission. Total hip arthroplasty has several surgical approaches including direct-anterior, direct-lateral, and direct-posterior approaches. It was hypothesized that the direct-anterior method is minimally invasive and would be able to lower complication rates.
Since retractor placement during surgery is the main cause of this complication, one purpose of this study was to investigate the proximity of the retractors to the femoral nerve during the various approaches to total hip arthroplasty using radiographic measures. By determining the most optimal location for the retractors in total hip arthroplasty and the consequences of this action, we hoped to develop a plan for physicians to decrease the incidence of femoral nerve palsy and decrease total cost of total hip arthroplasty amongst various high risk demographic groups.