Blood flow and microdialysis in the human femoral head

If it would be possible to detect lack of flow and/or the development of ischemia in bone, we might have a way of predicting whether a broken bone will heal. We established microdialysis (MD) and laser Doppler (LD) flow measurement in the human femoral head in order to be able to detect ischemia and measure changes in blood flow.

In 9 patients undergoing total hip arthroplasty for primary osteoarthrosis, two MD catheters were inserted into the femoral head through two drill holes after the blood flow had been visualized by LD. Then primary samples were collected with the femoral head in situ; thereafter, the head was removed and samples were collected over the following 4 hours ex vivo. The variables obtained by MD were concentrations of glucose, lactate, pyruvate, and glycerol in extracellular fluid.

The results showed development of ischemia with a statistically significant decrease in glucose concentration and elevation of the lactate/pyruvate ratio over time. The LD showed flow with the femoral head in situ and lack of flow when the femoral head was removed.

The use of MD was established in the human femoral head. Ischemic levels were detected within 2 h of cessation of blood flow in most patients.