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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 1, 21-25.
doi: 10.1302/0301-620X.89B1.18330  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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The effect of surgical approach on blood flow to the femoral head during resurfacing

A. Khan, BSc, MBBS, FRCS, Specialist Registrar in Trauma and Orthopaedics1; P. Yates, BSc, MBBS, FRCS (Trauma & Orth), Consultant Senior Lecturer and Orthopaedic Surgeon2; A. Lovering, BSc, PhD, Consultant Clinical Scientist3; G. C. Bannister, MD, MCh Orth, FRCS, FRCS Ed Orth, Consultant Orthopaedic Surgeon1; and R. F. Spencer, MD, FRCS, Consultant Orthopaedic Surgeon4

1 The Avon Orthopaedic Centre
2 Fremantle Hospital and The University of Western, Australia, Fremantle, Perth, 6160, Western Australia.
3 Bristol Centre for Antimicrobial Research and Evaluation, Department of Medical Microbiology, Southmead Hospital, Bristol, BS10 5NB, UK.
4 Weston General Hospital, Weston-super-Mare BS23 4TQ, UK.

Correspondence should be sent to Mr A. Khan at 24 Wycombe House, Grendon Street, London NW8 8SN, UK; e-mail: amerkhan441{at}hotmail.com

We determined the effect of the surgical approach on perfusion of the femoral head during hip resurfacing arthroplasty by measuring the concentration of cefuroxime in bone samples from the femoral head. A total of 20 operations were performed through either a transgluteal or an extended posterolateral approach.

The concentration of cefuroxime in bone was significantly greater when using the transgluteal approach (mean 15.7 mg/kg; 95% confidence interval 12.3 to 19.1) compared with that using the posterolateral approach (mean 5.6 mg/kg; 95% confidence interval 3.5 to 7.8; p < 0.001). In one patient, who had the operation through a posterolateral approach, cefuroxime was undetectable.

Using cefuroxime as an indirect measure of blood flow, the posterolateral approach was found to be associated with a significant reduction in the blood supply to the femoral head during resurfacing arthroplasty compared with the transgluteal approach.




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H. W. Amarasekera, M. L. Costa, P. Foguet, S. J. Krikler, U. Prakash, and D. R. Griffin
The blood flow to the femoral head/neck junction during resurfacing arthroplasty: A COMPARISON OF TWO APPROACHES USING LASER DOPPLER FLOWMETRY
J Bone Joint Surg Br, April 1, 2008; 90-B(4): 442 - 445.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General