Portal anatomy

Abstract

The constant description of new techniques requires a precise knowledge of the hip anatomy and common portal placement. In spite of that, the major part of complications described in the literature are related to the distraction of the joint and patient positioning some of them are directly connected with portal establishment. Two specific details have been taken into account: (1) the depth of the hip joint acting as a limiting factor and (2) there are significant neurovascular structures at risk in both anterior and posterior aspects of the joint. The different portals used to access the hip joint and surrounding structures are described (portal placement, pathway, and structures at risk): Central compartment: anterolateral portal, posterolateral portal, anterior portal, mid-anterior portal, mid-anterolateral portal, and distal lateral accessory portal Peripheral compartment: anterolateral portal, accessory anterolateral portal, superolateral portal, posterolateral portal, and mid-anterior portal Peritrochanteric space: proximal anterolateral accessory portal, peritrochanteric space portal, distal anterolateral accessory portal, anterior portal, distal posterior portal, and auxiliary posterolateral portal.