[Intraoperative Doppler ultrasound of the femoral vein for maintaining venous patency in hip joint prosthesis implantation].
OBJECTIVE
Is the femoral vein occluded during insertion of the stem? Can thrombembolic complications be reduced by avoiding occlusion?


METHODS
In a prospective randomized study 160 cemented stems were implanted from the anterolateral approach: 76 patients had conventional figure-of-four positioning of the femur, 84 patients had a modified position according to the blood flow registered by intraoperative Doppler sonography.


RESULTS
68.7% of the 84 femoral veins were completely occluded in the figure-of-four positioning. Only by reduction of this position and soft tissue release, venous flow could be demonstrated by sonography. Increased body mass index (BMI) and age correlated with occlusion (p = 0.0001 and p < 0.05). In the 84 patients no thrombembolic complication was found. In the control group 3 deep thromboses were revealed by venography (p = 0.105).


CONCLUSIONS
Doppler sonography helps guaranteeing venous drainage. A modified leg position should be aimed at especially in increased BMI and age.
Barden
B
B
Orthopädische Klinik und Poliklinik, Universität-GHS Essen, Hufelandstr. 55, 45122 Essen. b.barden@uni-essen.de
Kröger
K
K
Löer
F
F
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging*; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000517:prevention & control