Intraoperative Dopplersonography of the femoral vein for maintenance of venous flow in a hip endoprosthesis

Problem. is the femoral vein occluded during insertion of the stem! Can thr ombembolic complications be reduced by avoiding occlusion. Methods. In a prospective randomized study 160 cemented stems were implante d from the anterolateral approach: 76 patients had conventional figure-of-f our positioning of the femur, 84 patients had a modified position according to the blood flow registered by intaoperative Doppler sonography. Results. 68, 7% of the 84 femoral veins were completely occluded in the fig ure-of-four positioning. Only by reduction of this position and soft tissue release, venous flow could be demonstrated by sonography. Increased body m ass index (BMI) and age correlated with occlusion (p=0,0001 and p<0.05). In the 84 patients no thrombembolic complication was found. In the control gr oup 3 deep thromboses were revealed by venography (p=0,105). Conclusion. Doppler sonography helps guaranteeing venous drainage. A modifi ed leg position should be aimed at especially in increased BMI and age.