Purpose: To determine the accuracy and safety of non-image-guided modified mid-anterior and anterolateral approaches to the hip joint for arthrocentesis. Methods: Six pairs (n = 12) of human cadaveric hemipelvises underwent methylene blue hip injections through either a mid-anterior or an anterolateral approach. The distance from the midanterior approach to the lateral femoral cutaneous nerve (LFCN) was measured. Needle orientation was defined by a combination of 2 angles, calculated by the computer software analysis of digitized points. Distal Angle was defined as the angle between the lateral axis and an intermediate needle position, in the coronal plane, toward the distal axis. Anterior Angle was defined as the angle between the intermediate needle position of Distal Angle and the final position, toward the anterior axis. Results: Methylene blue was successfully injected into the joint capsule in all specimens. The mean distances from the needle to the LFCN for both the mid-anterior and anterolateral approaches were 19.3 +/- 7.9 and 80.3 +/- 28.3 mm, respectively. For the mid-anterior approach, Distal AngleM was a mean of 53.9 degrees +/- 14.9 degrees and Anterior AngleM was a mean of 33.4 degrees +/- 15.6 degrees. For the anterolateral approach, Distal AngleL was a mean of 14.5 degrees +/- 14.2 degrees and Anterior AngleL was a mean of 4.5 degrees +/- 13.6 degrees. Conclusions: This study showed that mid-anterior and anterolateral approaches for noneimage-guided hip injections or arthrocentesis can avoid the LFCN and be effectively performed in males, despite the exhibited variability in the quantitative descriptions of these techniques. The landmarks and measurements presented can be used as general guidelines for clinical studies regarding hip arthrocentesis and injections.
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