Acetabular blood flow during total hip arthroplasty.
OBJECTIVE
To determine the immediate effect of reaming and insertion of the acetabular component with and without cement on peri-acetabular blood flow during primary total hip arthroplasty (THA).


METHODS
A clinical experimental study.


METHODS
A tertiary referral and teaching hospital in Toronto.


METHODS
Sixteen patients (9 men, 7 women) ranging in age from 30 to 78 years and suffering from arthritis.


METHODS
Elective primary THA with a cemented (8 patients) and non-cemented (8 patients) acetabular component. All procedures were done by a single surgeon who used a posterior approach.


METHODS
Acetabular bone blood-flow measurements made with a laser Doppler flowmeter before reaming, after reaming and after insertion of the acetabular prosthesis.


RESULTS
Acetabular blood flow after prosthesis insertion was decreased by 52% in the non-cemented group (p < 0.001) and 59% in the cemented group (p < 0.001) compared with baseline (pre-reaming) values.


CONCLUSIONS
The significance of these changes in peri-acetabular bone blood flow during THA may relate to the extent of bony ingrowth, peri-prosthetic remodelling and ultimately the incidence of implant failure because of aseptic loosening.
elMaraghy
A W
AW
Musculoskeletal Research Laboratory, Department of Surgery, St. Michael's Hospital, Toronto, Ont.
Schemitsch
E H
EH
Waddell
J P
JP
D000077:Acetabulum / Q000098:blood supply*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods*; D001794:Blood Pressure; D001843:Bone Cements / Q000009:adverse effects*; D001862:Bone Resorption / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D017078:Laser-Doppler Flowmetry / Q000379:methods; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D015207:Osteoarthritis, Hip / Q000601:surgery; D011475:Prosthesis Failure
D001843:Bone Cements