Blood flow changes to the proximal femur during total hip arthroplasty.
OBJECTIVE
To determine the changes in perfusion to the proximal femur that occur during cemented and uncemented total hip arthroplasty (THA).


METHODS
Case series.


METHODS
A single tertiary-care centre.


METHODS
Twenty-two consecutive patients. Those who had undergone previous hip surgery or received systemic corticosteroid therapy were excluded.


METHODS
Cemented (11 procedures) or uncemented (12 procedures) THA.


METHODS
Changes in blood flow at the level of the proximal femur, measured with laser Doppler flowmetry at 4 different times during THA.


RESULTS
In both the cemented and the uncemented procedure overall proximal femoral blood flow was reduced (p = 0.002, p = 0.008, respectively). A greater reduction in overall proximal femoral perfusion was seen in the cemented group compared with the uncemented group (p = 0.004). This greater reduction in perfusion was seen primarily in the proximal femoral diaphysis (p = 0.004).


CONCLUSIONS
The extensive canal preparation involved with the cemented procedure or the introduction of bone cement under pressure into the femoral canal may contribute to the greater reduction in perfusion to the proximal femur.
Hupel
T M
TM
Musculoskeletal Research Laboratory, St. Michael's Hospital, University of Toronto, Ont.
Schemitsch
E H
EH
Aksenov
S A
SA
Waddell
J P
JP
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001794:Blood Pressure; D001843:Bone Cements; D005269:Femur / Q000098:blood supply*; D006452:Hemoglobinometry; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008875:Middle Aged; D012039:Regional Blood Flow
D001843:Bone Cements