Role of the extraosseus blood supply in osteoarthritic femoral heads

Schoeniger, R; Espinosa, N; Sierra, RJ; Leunig, M; Ganz, R (2009). Role of the extraosseus blood supply in osteoarthritic femoral heads. Clinical orthopaedics and related research, 467(9), pp. 2235-40. Heidelberg: Springer 10.1007/s11999-009-0839-1

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Blood perfusion to the femoral head might be endangered during the surgical approach or the preparation of the femoral head or both in hip resurfacing arthroplasty. The contribution of the intramedullary blood supply to the femoral head in osteoarthritis is questionable. Therefore, the contribution of the extraosseous blood supply to osteoarthritic femoral heads was measured intraoperatively to question if there is measurable blood flow between the epiphysis and metaphysis in osteoarthritic hips in case of extraosseus vessel damage. At defined points during surgery we acquired the epiphyseal and metaphyseal femoral head perfusion by high-energy laser Doppler flowmetry. Complete femoral neck osteotomy sparing the retinacular vessels to simulate intraosseous blood disruption showed unchanged epiphyseal blood flow compared to initial measurement after capsulotomy. The pulsatile signal disappeared after transection of the retinacular vessels. Based on these acute measurements, we conclude intramedullary blood vessels to the femoral head do not provide measurable blood supply to the epiphysis once the medial femoral circumflex artery or the retinacular vessels have been damaged. We recommend the use of a safe surgical approach for hip resurfacing and careful implantation of the femoral component to respect blood supply to the femoral head and neck region in hip resurfacing arthroplasty.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Ganz, Reinhold

ISSN:

0009-921X

ISBN:

19384562

Publisher:

Springer

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:09

Last Modified:

05 Dec 2022 14:21

Publisher DOI:

10.1007/s11999-009-0839-1

PubMed ID:

19384562

Web of Science ID:

000268483900007

BORIS DOI:

10.48350/30276

URI:

https://boris.unibe.ch/id/eprint/30276 (FactScience: 191689)

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