Femoral Vessel Blood Flow Is Preserved Throughout Direct Anterior Total Hip Arthroplasty

Area of Science:

• Orthopedic Surgery
• Vascular Physiology
• Surgical Approaches

Background:

• Total hip arthroplasty (THA) is a common orthopedic procedure.
• Posterolateral and anterolateral approaches for THA have been shown to disrupt femoral vessel blood flow.
• The impact of the direct anterior (DA) approach on femoral vasculature is not well-established.

Purpose of the Study:

• To evaluate the effect of the direct anterior (DA) approach for primary total hip arthroplasty (THA) on femoral artery and vein peak blood flow rates.
• To determine if the DA approach causes significant alterations or occlusion of the femoral vessels during the surgical procedure.

Main Methods:

• Ten patients undergoing primary DA THA were prospectively studied.
• Peak blood flow rates of the femoral artery and vein were measured using Doppler ultrasound.
• Measurements were taken at four key surgical points: incision, acetabular preparation, femoral preparation, and final reduction.

Main Results:

• Peak femoral arterial and venous blood flow showed non-significant decreases during acetabular and femoral preparation phases compared to baseline.
• At final reduction, femoral arterial peak flow was restored to baseline levels.
• Venous flow increased at final reduction, and importantly, no vessel occlusion was observed at any surgical stage.

Conclusions:

• The direct anterior (DA) approach for total hip arthroplasty (THA) appears to have a minimal and transient impact on femoral vessel blood flow.
• The procedure does not lead to significant vascular compromise or occlusion, indicating a favorable safety profile for the femoral vasculature.