Acetabular blood flow during total hip arthroplasty

OBJECTTVE: TO determine the immediate effect of reaming and insertion of th e acetabular component with and without cement on periacetabular blood flow during primary total hip arthroplasty (THA). DESIGN: A clinical experimental study. SETTING: A tertiary referral and teaching hospital in Toronto. PATIENTS: Sixteen patients (9 men, 7 women) ranging in age from 30 to 78 ye ars and suffering from arthritis. INTERVENTION: Elective primary THA with a cemented (8 patients) and nonceme nted (8 patients) acetabular component. All procedures were done by a singl e surgeon who used a posterior approach. MAIN OUTCOME MEASURE: Acetabular bone blood-flow measurements made with a l aser Doppler flowmeter before reaming, after reaming and after insertion of the acetabular prosthesis. RESULTS: Acetabular blood flow after prosthesis insertion was decreased by 52% in the noncemented group (p < 0.001) and 59% in the cemented group (p < 0.001) compared with baseline (prereaming) values. CONCLUSION: The significance of these changes in periacetabular bone blood now during THA may relate to the extent of bony ingrowth, periprosthetic re modelling and ultimately the incidence of implant failure because of asepti c loosening.