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Related Experiment Video

Updated: Feb 10, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Total Hip Replacement Provokes Endothelial Dysfunction.

Peter Poredos1, Ana Mavric2, Lara Leben2

  • 11 Department of Anaesthesiology and Perioperative Intensive Care, University Medical Centre Ljubljana, Ljubljana, Slovenia.

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|May 10, 2018
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Summary

Total hip replacement surgery significantly impairs endothelial function (EF), a key factor in cardiovascular health. This dysfunction, measured by flow-mediated dilation, persists for days after surgery, potentially increasing complication risks.

Keywords:
cardiovascular complicationsendothelial dysfunctionperioperative stress responsetotal hip replacement

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Biology
  • Orthopedic Surgery

Background:

  • Surgery increases perioperative complication risks.
  • Endothelial function (EF) is crucial for cardiovascular homeostasis and preventing thromboembolic events.
  • Understanding EF changes post-surgery is vital for managing patient risk.

Purpose of the Study:

  • To investigate the changes in endothelial function during the early postoperative period in patients undergoing total hip replacement (THR).
  • To assess the impact of THR on brachial artery flow-mediated dilation (FMD) and constriction.
  • To correlate changes in EF with the surgical procedure and patient recovery.

Main Methods:

  • Noninvasive assessment of endothelial function using flow-mediated dilation (FMD) and low flow-mediated constriction.
  • Measurements taken in 70 patients undergoing elective THR under spinal anesthesia.
  • Brachial artery FMD measured at baseline, 24 hours post-surgery, and 5–7 days post-surgery.

Main Results:

  • Baseline FMD was 12.3%, decreasing significantly to 7.3% at 24 hours post-THR (P < .001).
  • FMD showed partial recovery to 9.2% by 5–7 days but remained significantly lower than baseline (P < .001).
  • Total hip replacement duration averaged 85 minutes, with a mean hospital stay of 7 days.

Conclusions:

  • Total hip replacement surgery induces significant, immediate endothelial dysfunction.
  • This endothelial dysfunction persists into the early postoperative period, indicating a sustained impact on cardiovascular homeostasis.
  • The observed endothelial impairment may contribute to increased cardiovascular complications following THR.