title: The effect of surgical approach on blood flow to the femoral head during resurfacing.
abstract: We determined the effect of the surgical approach on perfusion of the femoral head during hip resurfacing arthroplasty by measuring the concentration of cefuroxime in bone samples from the femoral head. A total of 20 operations were performed through either a transgluteal or an extended posterolateral approach. The concentration of cefuroxime in bone was significantly greater when using the transgluteal approach (mean 15.7 mg/kg; 95% confidence interval 12.3 to 19.1) compared with that using the posterolateral approach (mean 5.6 mg/kg; 95% confidence interval 3.5 to 7.8; p < 0.001). In one patient, who had the operation through a posterolateral approach, cefuroxime was undetectable. Using cefuroxime as an indirect measure of blood flow, the posterolateral approach was found to be associated with a significant reduction in the blood supply to the femoral head during resurfacing arthroplasty compared with the transgluteal approach.
authors.affiliation: The Avon Orthopaedic Centre, The University of Western, Australia, Fremantle, Perth, Western Australia.
authors.forename: A
authors.initials: A
authors.lastname: Khan
authors.forename: P
authors.initials: P
authors.lastname: Yates
authors.forename: A
authors.initials: A
authors.lastname: Lovering
authors.forename: G C
authors.initials: GC
authors.lastname: Bannister
authors.forename: R F
authors.initials: RF
authors.lastname: Spencer
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002444:Cefuroxime / Q000493:pharmacokinetics; D005260:Female; D005270:Femur Head / Q000098:blood supply* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011446:Prospective Studies; D012039:Regional Blood Flow
chemical_list: D000900:Anti-Bacterial Agents; D002444:Cefuroxime