Greater trochanteric blood flow during total hip arthroplasty using a posterior approach

The authors investigated the effect of a posterior surgical approach on the local femoral blood supply during primary total hip arthroplasty, Greater trochanteric blood flow measurements were made with a laser Doppler flowmet er at intervals during the performance of eight uncemented and nine cemente d total hip arthroplasties. Complete detachment of the quadratus femoris wa s associated with a significant decrease in trochanteric blood flow in the uncemented and cemented groups. The lowest perfusion levels during the proc edure were seen transiently with posterior dislocation of the femoral head, after which trochanteric perfusion was decreased by 66% in the uncemented group, and 61% in the cemented group compared with baseline values. Blood f low remained approximately half of baseline values after insertion of the f emoral prosthesis in the uncemented and cemented groups. These changes in g reater trochanteric blood flow may serve as a marker for reduction in proxi mal femoral blood flow during total hip arthroplasty, and subsequently rela te to the extent of bony ingrowth, periprosthetic bone loss, and ultimately the incidence of implant failure caused by aseptic loosening.