title: The distribution of vascular foramina at the femoral head/neck junction: implications for resurfacing arthroplasty.
abstract: Reaming for resurfacing arthroplasty may endanger the blood supply at the head-neck junction, possibly predisposing to osteonecrosis and femoral neck fracture. The current study hypothesizes that reaming endangers femoral head vasculature. Vascular foramina were identified on 16 cadaveric femora and registered on computed tomographic models. Virtual reaming was performed after templating of resurfacing components. Almost half (41.8%) of foramina was located in the anterosuperior quadrant. Loss of foramina after reaming averaged 28% (P = .03), with up to 34.6% and 33.1% loss in the anterosuperior and posterosuperior quadrants, respectively. Reaming for resurfacing arthroplasty endangers a substantial number of vascular foramina. Notching or malpositioning of components may worsen injury to the vascular supply and could subsequently increase the risk of implant failure.
authors.affiliation: Hospital for Special Surgery, Department of Orthopaedic Surgery, New York, New York, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Dy
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Thompson
authors.forename: Molly M
authors.initials: MM
authors.lastname: Usrey
authors.forename: Philip C
authors.initials: PC
authors.lastname: Noble
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D002102:Cadaver; D003198:Computer Simulation; D005260:Female; D005270:Femur Head / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D005272:Femur Neck / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013499:Surface Properties; D014057:Tomography, X-Ray Computed