Blood flow changes to the proximal femur during total hip arthroplasty.

OBJECTIVE: To determine the changes in perfusion to the proximal femur that occur during cemented and uncemented total hip arthroplasty (THA). DESIGN: Case series. SETTING: A single tertiary-care centre. PATIENTS: Twenty-two consecutive patients. Those who had undergone previous hip surgery or received systemic corticosteroid therapy were excluded. INTERVENTION: Cemented (11 procedures) or uncemented (12 procedures) THA. MAIN OUTCOME MEASURE: Changes in blood flow at the level of the proximal femur, measured with laser Doppler flowmetry at 4 different times during THA. RESULTS: In both the cemented and the uncemented procedure overall proximal femoral blood flow was reduced (p = 0.002, p = 0.008, respectively). A greater reduction in overall proximal femoral perfusion was seen in the cemented group compared with the uncemented group (p = 0.004). This greater reduction in perfusion was seen primarily in the proximal femoral diaphysis (p = 0.004). CONCLUSION: The extensive canal preparation involved with the cemented procedure or the introduction of bone cement under pressure into the femoral canal may contribute to the greater reduction in perfusion to the proximal femur.