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Acetabular blood flow during total hip arthroplasty
A W elMaraghy1, E H Schemitsch, J P Waddell
1Musculoskeletal Research Laboratory, Department of Surgery, St. Michael's Hospital, Toronto, Ont.
Objective:
To determine the immediate effect of reaming and insertion of the acetabular component with and without cement on peri-acetabular blood flow during primary total hip arthroplasty (THA).
Design:
A clinical experimental study.
Setting:
A tertiary referral and teaching hospital in Toronto.
Patients:
Sixteen patients (9 men, 7 women) ranging in age from 30 to 78 years and suffering from arthritis.
Intervention:
Elective primary THA with a cemented (8 patients) and non-cemented (8 patients) acetabular component. All procedures were done by a single surgeon who used a posterior approach.
Main Outcome Measure:
Acetabular bone blood-flow measurements made with a laser Doppler flowmeter before reaming, after reaming and after insertion of the acetabular prosthesis.
Results:
Acetabular blood flow after prosthesis insertion was decreased by 52% in the non-cemented group (p < 0.001) and 59% in the cemented group (p < 0.001) compared with baseline (pre-reaming) values.
Conclusion:
The significance of these changes in peri-acetabular bone blood flow during THA may relate to the extent of bony ingrowth, peri-prosthetic remodelling and ultimately the incidence of implant failure because of aseptic loosening.