During the posterior approach to the hip

During the posterior approach to the hip, the most predictable course of the sciatic nerve is deep to the piriformis and superficial to the short external rotators exiting above the superior gemellus. As such, most recommend identification of the sciatic nerve by palpation in primary THA. In revision THA, many advocate identification of the sciatic nerve by both palpation and direct visualization.
The most common anatomic variant in the relationship of the short external rotators and the sciatic nerve is with the sciatic nerve traveling between the capsule and the short external rotators exiting below the superior gemellus.

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