Anatomical Variations Encountered During the Posterior Approach to the Hip Joint.
7 affiliations
- 1Department of Anatomy, Faculty of Health Sciences, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece.
- 2School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece.
- 3Department of Orthopaedics and Traumatology, University Hospital Queen Giovanna-ISUL, Medical University of Sofia, 1431 Sofia, Bulgaria.
- 4Faculty of Medicine, Andrés Bello University, Santiago 8370146, Chile.
- 5Department of Chemical and Biological Sciences, Faculty of Health Sciences, Bernardo O'Higgins University, Santiago 8370993, Chile.
- 6GIAVAL Research Group, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Valencia, 46001 Valencia, Spain.
- 7Grupo de Investigación Bienestar, Salud y Sociedad, Escuela de Psicología y Educación, Universidad de Las América, Quito 170124, Ecuador.
Abstract
The posterior approach to the hip joint remains widely used for primary total hip arthroplasty because it provides extensive exposure while preserving the abductor mechanism. Safe execution, however, depends on recognizing anatomical variation within the gluteal region. This narrative review synthesizes variations encountered sequentially during posterior hip exposure and organizes them into superficial, muscular, neurovascular, and osseous domains. Key considerations include branching patterns of the posterior femoral cutaneous and superior cluneal nerves, morphological variation in the short external rotators and quadratus femoris, variation in the sciatic nerve-piriformis relationship, persistent embryonic vessels, os acetabuli, and proximal femoral morphology. The evidence base is heterogeneous and is dominated by cadaveric and anatomical studies, with several prevalence estimates derived from small series. Accordingly, reported frequencies should be interpreted in light of study design and sample size. By arranging these findings according to surgical planes and distinguishing documented clinical complications from anatomy-based theoretical risks, this review provides a practical anatomical roadmap for preoperative planning and intraoperative orientation. The direct effect of many variants on surgical outcomes remains uncertain and warrants prospective clinical study.
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BibTeX
@article{katsogiannis2026anatomical,
title = {{Anatomical Variations Encountered During the Posterior Approach to the Hip Joint.}},
author = {Dimitrios Katsogiannis and George Triantafyllou and Christos Koutserimpas and Fotis Demetriou and Georgi P Georgiev and George Tsakotos and Juan Jose Valenzuela-Fuenzalida and Juan Sanchis-Gimeno and Jose E León-Rojas and Maria Piagkou},
journal = {Journal of functional morphology and kinesiology},
year = {2026},
month = oct,
doi = {10.3390/jfmk11040422},
url = {https://europepmc.org/article/MED/42924701},
note = {CC BY},
}
RIS
TY - JOUR
TI - Anatomical Variations Encountered During the Posterior Approach to the Hip Joint.
AU - Dimitrios Katsogiannis
AU - George Triantafyllou
AU - Christos Koutserimpas
AU - Fotis Demetriou
AU - Georgi P Georgiev
AU - George Tsakotos
AU - Juan Jose Valenzuela-Fuenzalida
AU - Juan Sanchis-Gimeno
AU - Jose E León-Rojas
AU - Maria Piagkou
PY - 2026
DA - 2026/10/15
JO - Journal of functional morphology and kinesiology
DO - 10.3390/jfmk11040422
UR - https://europepmc.org/article/MED/42924701
AB - The posterior approach to the hip joint remains widely used for primary total hip arthroplasty because it provides extensive exposure while preserving the abductor mechanism. Safe execution, however, depends on recognizing anatomical variation within the gluteal region. This narrative review synthesizes variations encountered sequentially during posterior hip exposure and organizes them into superficial, muscular, neurovascular, and osseous domains. Key considerations include branching patterns of the posterior femoral cutaneous and superior cluneal nerves, morphological variation in the short external rotators and quadratus femoris, variation in the sciatic nerve-piriformis relationship, persistent embryonic vessels, os acetabuli, and proximal femoral morphology. The evidence base is heterogeneous and is dominated by cadaveric and anatomical studies, with several prevalence estimates derived from small series. Accordingly, reported frequencies should be interpreted in light of study design and sample size. By arranging these findings according to surgical planes and distinguishing documented clinical complications from anatomy-based theoretical risks, this review provides a practical anatomical roadmap for preoperative planning and intraoperative orientation. The direct effect of many variants on surgical outcomes remains uncertain and warrants prospective clinical study.
SN - 2411-5142
ER -