Total hip replacement, lower limb blood flow and venous thrombogenesis

The effect of Charnley cemented total hip replacement on venous blood flow in the legs and its relationship to deep-vein thrombosis were investigated in 413 patients. Blood flow was measured using strain-gauge plethysmography before operation, after surgery, and after discharge from hospital. There was a significant reduction in both venous capacitance and venous outflow, affecting both legs but greater in the operated leg. Venous flow remained significantly below preoperative levels in the operated leg six weeks after surgery. There was a highly significant correlation between the degree of reduction in blood flow and the development of postoperative deep-vein thrombosis. Venous stasis was shown to be a major factor in venous thrombogenesis.