{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T08:23:37Z","timestamp":1767169417528,"version":"3.48.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012330","name":"Okayama University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012330","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Femoral nerve palsy and femoral artery injury are serious complications of total hip arthroplasty. However, few studies have compared the anatomical positions of these structures in different patient positions. This study aimed to compare the anatomical positions of the femoral nerve and artery in the lateral and supine positions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This multicenter retrospective study included 111 patients who underwent lateral and supine computed tomography (CT) from 2016 to 2023. CT images were reconstructed in the anterior pelvic plane. The horizontal distance from the anterior margin of the acetabulum to the femoral nerve (Distance N) and femoral artery (Distance A) was measured. The difference in Distance N between the two positions (\u0394Lateral\u2013supine Distance N) was calculated by subtracting the supine value from the lateral value.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The average Distance N was 26.5\u2009\u00b1\u20095.1\u00a0mm in the lateral position and 21.1\u2009\u00b1\u20094.4\u00a0mm in the supine position, with the nerve located significantly closer to the acetabulum in the supine position (P\u2009&lt;\u20090.001). Similarly, the average Distance A was 26.8\u2009\u00b1\u20095.4\u00a0mm in the lateral position and 20.4\u2009\u00b1\u20094.9\u00a0mm in the supine position (P\u2009&lt;\u20090.001). Multiple regression analysis showed that Distance N in the lateral position was significantly shorter in female patients and those with low body weight. In addition, low body weight correlated with a smaller \u0394Lateral\u2013supine Distance N.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The femoral nerve and artery are located closer to the anterior margin of the acetabulum in the supine position than in the lateral position. Low body weight was an independent predictor of shorter Distance N in both positions and a smaller \u0394Lateral\u2013supine Distance N. These findings underscore the importance of considering patient positioning during total hip arthroplasty, particularly in patients with low body weight, to reduce neurovascular risks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-025-05968-9","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T15:31:41Z","timestamp":1752593501000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Changes in the anatomical positions of the femoral nerve and artery in the lateral and supine positions: a multicenter retrospective study"],"prefix":"10.1007","volume":"145","author":[{"given":"Ryuichiro","family":"Okuda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomonori","family":"Tetsunaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Tetsunaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Koura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiro","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasutaka","family":"Masada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisanori","family":"Ikuma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Komatsubara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Okazaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshifumi","family":"Ozaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"5968_CR1","doi-asserted-by":"publisher","first-page":"963","DOI":"10.2106\/00004623-200405000-00012","volume":"86","author":"O Ethgen","year":"2004","unstructured":"Ethgen O, Bruy\u00e8re O, Richy F, Dardennes C, Reginster JY (2004) Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am 86:963\u2013974. https:\/\/doi.org\/10.2106\/00004623-200405000-00012","journal-title":"J Bone Joint Surg Am"},{"key":"5968_CR2","doi-asserted-by":"publisher","first-page":"1508","DOI":"10.1016\/S0140-6736(07)60457-7","volume":"370","author":"ID Learmonth","year":"2007","unstructured":"Learmonth ID, Young C, Rorabeck C (2007) The operation of the century: total hip replacement. Lancet 370:1508\u20131519. https:\/\/doi.org\/10.1016\/S0140-6736(07)60457-7","journal-title":"Lancet"},{"key":"5968_CR3","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.arth.2014.08.024","volume":"30","author":"D Shubert","year":"2015","unstructured":"Shubert D, Madoff S, Milillo R, Nandi S (2015) Neurovascular structure proximity to acetabular retractors in total hip arthroplasty. J Arthroplasty 30:145\u2013148. https:\/\/doi.org\/10.1016\/j.arth.2014.08.024","journal-title":"J Arthroplasty"},{"key":"5968_CR4","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1016\/j.arth.2017.10.050","volume":"33","author":"AN Fleischman","year":"2018","unstructured":"Fleischman AN, Rothman RH, Parvizi J (2018) Femoral nerve palsy following total hip arthroplasty: incidence and course of recovery. J Arthroplasty 33:1194\u20131199. https:\/\/doi.org\/10.1016\/j.arth.2017.10.050","journal-title":"J Arthroplasty"},{"key":"5968_CR5","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1007\/s00402-019-03317-1","volume":"140","author":"M Thaler","year":"2020","unstructured":"Thaler M, Lechner R, Dammerer D et al (2020) The direct anterior approach: treating periprosthetic joint infection of the hip using two-stage revision arthroplasty. Arch Orthop Trauma Surg 140:255\u2013262. https:\/\/doi.org\/10.1007\/s00402-019-03317-1","journal-title":"Arch Orthop Trauma Surg"},{"key":"5968_CR6","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s00402-023-05077-5","volume":"144","author":"Y-W Li","year":"2024","unstructured":"Li Y-W, Yu S-W, Yeh J-H et al (2024) First 100 total hip arthroplasties performed by a young surgeon using the direct anterior approach: learning curve and complications. Arch Orthop Trauma Surg 144:927\u2013935. https:\/\/doi.org\/10.1007\/s00402-023-05077-5","journal-title":"Arch Orthop Trauma Surg"},{"key":"5968_CR7","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1097\/00003086-197906000-00014","volume":"141","author":"B Nachbur","year":"1979","unstructured":"Nachbur B, Meyer RP, Verkkala K, Z\u00fcrcher R (1979) The mechanisms of severe arterial injury in surgery of the hip joint. Clin Orthop Relat Res 141:122\u2013133. https:\/\/doi.org\/10.1097\/00003086-197906000-00014","journal-title":"Clin Orthop Relat Res"},{"key":"5968_CR8","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/0741-5214(90)90301-P","volume":"11","author":"NA Shoenfeld","year":"1990","unstructured":"Shoenfeld NA, Stuchin SA, Pearl R, Haveson S (1990) The management of vascular injuries associated with total hip arthroplasty. J Vasc Surg 11:549\u2013555","journal-title":"J Vasc Surg"},{"key":"5968_CR9","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/S0030-5898(20)31733-8","volume":"23","author":"RC Wasielewski","year":"1992","unstructured":"Wasielewski RC, Crossett LS, Rubash HE (1992) Neural and vascular injury in total hip arthroplasty. Orthop Clin North Am 23:219\u2013235. https:\/\/doi.org\/10.1016\/S0030-5898(20)31733-8","journal-title":"Orthop Clin North Am"},{"key":"5968_CR10","first-page":"231","volume":"45","author":"N Slater","year":"2000","unstructured":"Slater N, Singh R, Senasinghe N et al (2000) Pressure monitoring of the femoral nerve during total hip replacement: an explanation for iatropathic palsy. J R Coll Surg Edinb 45:231\u2013233","journal-title":"J R Coll Surg Edinb"},{"key":"5968_CR11","doi-asserted-by":"publisher","first-page":"531","DOI":"10.3109\/17453678008990836","volume":"51","author":"LF Solheim","year":"1980","unstructured":"Solheim LF, Hagen R (1980) Femoral and sciatic neuropathies after total hip arthroplasty. Acta Orthop Scand 51:531\u2013534. https:\/\/doi.org\/10.3109\/17453678008990836","journal-title":"Acta Orthop Scand"},{"key":"5968_CR12","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1001\/archsurg.1981.01380150063017","volume":"116","author":"JC Aust","year":"1981","unstructured":"Aust JC, Bredenberg CE, Murray DG (1981) Mechanisms of arterial injuries associated with total hip replacement. Arch Surg 116:345\u2013349. https:\/\/doi.org\/10.1001\/archsurg.1981.01380150063017","journal-title":"Arch Surg"},{"key":"5968_CR13","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2021.102817","volume":"107","author":"R Takada","year":"2021","unstructured":"Takada R, Jinno T, Miyatake K et al (2021) Does surgical body position influence the risk for neurovascular injury in total hip arthroplasty? A magnetic resonance imaging study. Orthop Traumatol Surg Res 107:102817. https:\/\/doi.org\/10.1016\/j.otsr.2021.102817","journal-title":"Orthop Traumatol Surg Res"},{"key":"5968_CR14","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1038\/bmt.2012.244","volume":"48","author":"Y Kanda","year":"2013","unstructured":"Kanda Y (2013) Investigation of the freely available easy-to-use software \u201cEZR\u201d for medical statistics. Bone Marrow Transplant 48:452\u2013458. https:\/\/doi.org\/10.1038\/bmt.2012.244","journal-title":"Bone Marrow Transplant"},{"key":"5968_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s002640050107","volume":"21","author":"M Oldenburg","year":"1997","unstructured":"Oldenburg M, M\u00fcller RT (1997) The frequency, prognosis and significance of nerve injuries in total hip arthroplasty. Int Orthop 21:1\u20133. https:\/\/doi.org\/10.1007\/s002640050107","journal-title":"Int Orthop"},{"key":"5968_CR16","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1302\/0301-620x78b6.6603","volume":"78","author":"AE Weale","year":"1996","unstructured":"Weale AE, Newman P, Ferguson IT, Bannister GC (1996) Nerve injury after posterior and direct lateral approaches for hip replacement. A clinical and electrophysiological study. J Bone Joint Surg Br 78:899\u2013902. https:\/\/doi.org\/10.1302\/0301-620x78b6.6603","journal-title":"J Bone Joint Surg Br"},{"key":"5968_CR17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0217068","volume":"14","author":"C Hoshino","year":"2019","unstructured":"Hoshino C, Koga D, Koyano G et al (2019) Femoral nerve palsy following primary total hip arthroplasty with the direct anterior approach. PLoS ONE 14:e0217068. https:\/\/doi.org\/10.1371\/journal.pone.0217068","journal-title":"PLoS ONE"},{"key":"5968_CR18","doi-asserted-by":"publisher","first-page":"137","DOI":"10.2106\/JBJS.19.00667","volume":"102","author":"K Yoshino","year":"2020","unstructured":"Yoshino K, Nakamura J, Hagiwara S et al (2020) Anatomical implications regarding femoral nerve palsy during a direct anterior approach to total hip arthroplasty: a cadaveric study. J Bone Joint Surg Am 102:137\u2013142. https:\/\/doi.org\/10.2106\/JBJS.19.00667","journal-title":"J Bone Joint Surg Am"},{"key":"5968_CR19","doi-asserted-by":"publisher","first-page":"572","DOI":"10.2106\/JBJS.17.00679","volume":"100","author":"T Ishimatsu","year":"2018","unstructured":"Ishimatsu T, Kinoshita K, Nishio J et al (2018) Motor-evoked potential analysis of femoral nerve status during the direct anterior approach for total hip arthroplasty. J Bone Joint Surg Am 100:572\u2013577. https:\/\/doi.org\/10.2106\/JBJS.17.00679","journal-title":"J Bone Joint Surg Am"},{"key":"5968_CR20","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.jos.2021.09.007","volume":"28","author":"S Kinoshita","year":"2023","unstructured":"Kinoshita S, Ishimatsu T, Suzuki M et al (2023) Femoral nerve status during the anterolateral approach for total hip arthroplasty: motor-evoked potential analysis and an influencing factor. J Orthop Sci 28:152\u2013155. https:\/\/doi.org\/10.1016\/j.jos.2021.09.007","journal-title":"J Orthop Sci"},{"key":"5968_CR21","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1186\/s12891-023-06947-0","volume":"24","author":"Y Tsurumi","year":"2023","unstructured":"Tsurumi Y, Hagiwara S, Horikoshi T et al (2023) Leg position effects on the femoral neurovascular bundle location during a direct anterior approach total hip arthroplasty: a radiographic study. BMC Musculoskelet Disord 24:824. https:\/\/doi.org\/10.1186\/s12891-023-06947-0","journal-title":"BMC Musculoskelet Disord"},{"key":"5968_CR22","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1007\/s10047-019-01116-4","volume":"22","author":"Y Maeda","year":"2019","unstructured":"Maeda Y, Nakamura N, Takao M, Hamada H, Sugano N (2019) Risk of injury to the femoral blood vessels based on the extent of acetabular dysplasia in total hip arthroplasty. J Artif Organs 22:324\u2013329. https:\/\/doi.org\/10.1007\/s10047-019-01116-4","journal-title":"J Artif Organs"},{"key":"5968_CR23","first-page":"461","volume":"32","author":"G Starcevi\u0107-Klasan","year":"2008","unstructured":"Starcevi\u0107-Klasan G, Cvijanovi\u0107 O, Peharec S et al (2008) Anthropometric parameters as predictors for iliopsoas muscle strength in healthy girls and in girls with adolescent idiopathic scoliosis. Coll Antropol 32:461\u2013466","journal-title":"Coll Antropol"},{"key":"5968_CR24","doi-asserted-by":"publisher","first-page":"20215","DOI":"10.1038\/s41598-020-77351-0","volume":"10","author":"JA Fitzpatrick","year":"2020","unstructured":"Fitzpatrick JA, Basty N, Cule M et al (2020) Large-scale analysis of iliopsoas muscle volumes in the UK Biobank. Sci Rep 10:20215. https:\/\/doi.org\/10.1038\/s41598-020-77351-0","journal-title":"Sci Rep"},{"key":"5968_CR25","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1007\/s00402-023-05146-9","volume":"144","author":"Y Okamoto","year":"2024","unstructured":"Okamoto Y, Wakama H, Matsuyama J et al (2024) The psoas muscle index as a useful predictor of total hip arthroplasty outcomes. Arch Orthop Trauma Surg 144:1763\u20131772. https:\/\/doi.org\/10.1007\/s00402-023-05146-9","journal-title":"Arch Orthop Trauma Surg"},{"key":"5968_CR26","doi-asserted-by":"publisher","first-page":"e337","DOI":"10.1097\/BOT.0000000000002047","volume":"35","author":"G Moreno","year":"2021","unstructured":"Moreno G, Ponce de Le\u00f3n JG, Rickman M (2021) The anatomic relevance of the iliopectineal fascia for acetabular surgery. J Orthop Trauma 35:e337\u2013e340. https:\/\/doi.org\/10.1097\/BOT.0000000000002047","journal-title":"J Orthop Trauma"}],"container-title":["Archives of Orthopaedic and Trauma Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-025-05968-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00402-025-05968-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00402-025-05968-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T08:19:15Z","timestamp":1767169155000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00402-025-05968-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,15]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["5968"],"URL":"https:\/\/doi.org\/10.1007\/s00402-025-05968-9","relation":{},"ISSN":["1434-3916"],"issn-type":[{"type":"electronic","value":"1434-3916"}],"subject":[],"published":{"date-parts":[[2025,7,15]]},"assertion":[{"value":"1 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"373"}}