{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:11:55Z","timestamp":1777677115143,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T00:00:00Z","timestamp":1708300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Nerve injury is one of the most serious complications of total hip arthroplasty (THA). It is suspected to be a result from nerve compression or direct injury caused by an acetabular retractor. The anatomical relationship between the acetabular rim and the femoral and sciatic nerves, including hip motion, has not been investigated. This study aimed to identify the optimal position for retractor insertion during THA to prevent nerve damage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 28 hip joints from 14 freshly frozen cadavers were used. Using an anterolateral approach, each cadaver was immobilised in the lateral decubitus position and deployed to measure the distance between the nerves and the acetabular rim, while the hip joint was changed to the extension, neutral, and flexion positions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Three femoral nerves were closest to the anterior margin of the acetabulum at 90\u00b0 and 120\u00b0 of extension and farthest away at 30\u00b0 of flexion. The sciatic nerve was closest to the posterior margin of the acetabulum at 90\u00b0 and 120\u00b0 of flexion and farthest away at 30\u00b0 and 150\u00b0 of extension compared with the other points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>To prevent nerve damage during THA, we suggest that the retractor be inserted at the points where the nerves are the farthest away, such as at 30\u00b0 and 150\u00b0. The femoral and sciatic nerves vary in their movements depending on the hip position. Therefore, the safe insertion of a retractor is recommended for hip flexion of the femoral nerve and extension of the sciatic nerve. Additionally, it is important to carefully insert the retractor along the acetabular margin without penetrating the joint capsule. Overall, this study provides valuable insights into the anatomical location and movement of the femoral and sciatic nerves in relation to hip motion and can help inform surgical techniques for safer THA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11207000241227399","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T04:37:55Z","timestamp":1708317475000},"page":"459-466","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Optimal retractor insertion point for nerve safety during total hip arthroplasty: an anatomical study on the femoral and sciatic nerves in relation to hip motion"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7785-9741","authenticated-orcid":false,"given":"Masakazu","family":"Okamoto","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9798-6125","authenticated-orcid":false,"given":"Yoshinobu","family":"Uchihara","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichiro","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Nara Medical University, Kashihara, Nara, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Inagaki","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Nara Medical University, Kashihara, Nara, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pasuk","family":"Mahakkanukrauh","sequence":"additional","affiliation":[{"name":"Department of Anatomy Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand"},{"name":"Excellence Centre in Osteology Research and Training Centre (ORCT), Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhito","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,2,19]]},"reference":[{"key":"bibr1-11207000241227399","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198310000-00034"},{"key":"bibr2-11207000241227399","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2017.10.011"},{"key":"bibr3-11207000241227399","first-page":"239","volume":"95","author":"Wilson JN","year":"1973","journal-title":"Clin Orthop Relat Res"},{"key":"bibr4-11207000241227399","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200512000-00004"},{"key":"bibr5-11207000241227399","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197658010-00011"},{"key":"bibr6-11207000241227399","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199173070-00018"},{"key":"bibr7-11207000241227399","doi-asserted-by":"publisher","DOI":"10.5301\/hipint.5000352"},{"key":"bibr8-11207000241227399","doi-asserted-by":"publisher","DOI":"10.1007\/s002640050107"},{"key":"bibr9-11207000241227399","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.00679"},{"key":"bibr10-11207000241227399","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.36.2000255"},{"key":"bibr11-11207000241227399","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-019-02611-3"},{"key":"bibr12-11207000241227399","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.00667"},{"key":"bibr13-11207000241227399","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000150294.81825.8c"},{"key":"bibr14-11207000241227399","doi-asserted-by":"publisher","DOI":"10.5301\/hip.2011.6491"},{"key":"bibr15-11207000241227399","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E"},{"key":"bibr16-11207000241227399","first-page":"191","volume":"37","author":"Brown GD","year":"2008","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"bibr17-11207000241227399","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2014.08.024"},{"key":"bibr18-11207000241227399","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-016-0365-2"},{"key":"bibr19-11207000241227399","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-018-0847-5"}],"container-title":["HIP International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11207000241227399","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11207000241227399","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11207000241227399","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:22:51Z","timestamp":1777450971000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11207000241227399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,19]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1177\/11207000241227399"],"URL":"https:\/\/doi.org\/10.1177\/11207000241227399","relation":{},"ISSN":["1120-7000","1724-6067"],"issn-type":[{"value":"1120-7000","type":"print"},{"value":"1724-6067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,19]]}}}