title: The effect of a modified posterior approach on blood flow to the femoral head during hip resurfacing.
abstract: The deep branch of the medial femoral circumflex artery is vulnerable to injury during posterior approaches to the hip. We modified the posterior approach during hip resurfacing in 10 patients by dividing the short external rotators 2 cm from their insertion into the femur. The cefuroxime concentrations in bone samples from the femoral heads were compared with results for the extended posterolateral approach from previous published work. There was no difference between the concentration of cefuroxime in bone when using the modified posterior approach (mean 5.6 mg/kg; CI 3.6 - 7.8) compared to the extended posterolateral approach (mean 5.6 mg/kg; CI 3.5 - 7.8; p=0.95). The similarity in femoral head perfusion between approaches suggests that the blood supply may be impaired further by capsulotomy and capsulectomy rather than by damage to the deep branch of the MFCA alone.
authors.affiliation: The Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK. amerkhan441@hotmail.com
authors.forename: Amer
authors.initials: A
authors.lastname: Khan
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Lovering
authors.forename: Gordon C
authors.initials: GC
authors.lastname: Bannister
authors.forename: Robert F
authors.initials: RF
authors.lastname: Spencer
authors.forename: Nadi
authors.initials: N
authors.lastname: Kalap
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000032:analysis*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods*; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D002444:Cefuroxime / Q000032:analysis*; D005260:Female; D005270:Femur Head / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D002444:Cefuroxime