Damage to the Superior Gluteal Nerve During the Direct Lateral Approach to the Hip: A Cadaveric Study

The direct lateral approach to the hip is one of the most commonly used surgical approaches for hip arthroplasty. The inferior division of the superior gluteal nerve (SGN) is the main nerve supply to the abductor muscles of the hip and may be damaged during this approach. The exact incidence of permanent damage to the SGN is not known. The present study is based on cadaveric dissection of the SGN after a surgical approach to the hip joint for hip arthroplasty. The inferior division of the SGN was found to be damaged in 3 (6.8%) of 44 cases. We conclude that a true “safe zone” does not exist when using a direct lateral approach. We also found out that the incidence of physical damage to the SGN is rare and depends largely on the branching pattern of the nerve.