Innervation of the Posterior Hip Capsule: A Cadaveric Study

Ameet S. Nagpal, Caroline Brennick, Annette P. Occhialini, Jennifer Gabrielle Leet, Tyler Scott Clark, Omid B. Rahimi, Kendall Hulk, Brittany Bickelhaupt, Maxim S. Eckmann

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: Recent studies of hip anatomy have turned to the posterior hip capsule to better understand the anatomic location of the posterior capsular sensory branches and identify nerves with potential for neural blockade. Current literature has shown the posterior hip capsule is primarily supplied by branches from the sciatic nerve, nerve to quadratus femoris, and superior gluteal nerve (1, 2). This cadaveric study investigated the gross anatomy of the posterior hip, while also identifying potential targets for hip analgesia, with emphasis on the superior gluteal nerve and nerve to quadratus femoris. DESIGN: Cadaveric study. SETTING: UT Health San Antonio Anatomy Lab. METHODS: In total, 10 total cadavers (18 hips total), were posteriorly dissected identifying nerve to quadratus femoris, superior gluteal nerve, and sciatic nerve. Nerves were labeled with radio-opaque markers. Following the dissections, fluoroscopic images were obtained at sequential angles to identify neural anatomy and help expand anatomic knowledge for interventional pain procedures. RESULTS: The posterior hip capsule was supplied by the sciatic nerve in 1/16 hips, the nerve to quadratus femoris in 15/18 hips, and the superior gluteal nerve in 6/18 hips. CONCLUSIONS: The nerve to quadratus femoris reliably innervates the posterior hip joint. Both the sciatic nerve and superior gluteal nerve have small articular branches that may be involved in posterior hip innervation, but this is not seen commonly. The results of this study may elucidate novel therapeutic targets for treatment of chronic refractory hip pain (i.e., the nerve to quadratus femoris).

Original languageEnglish (US)
Pages (from-to)1072-1079
Number of pages8
JournalPain medicine (Malden, Mass.)
Volume22
Issue number5
DOIs
StatePublished - May 21 2021

Keywords

  • Cadaver
  • Cadaveric Dissection
  • Hip
  • Joint Innervation
  • Peripheral Joint
  • Radiofrequency

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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