Surgical hip dislocation through a modified direct lateral approach: real-time perfusion monitoring

• Main Authors: Mohamad J. Halawi, MD, David P. Brigati, MD, Peter J. Brooks, MD
• Format: Article
• Language: English
• Published: Elsevier 2019-09-01
• Series: Arthroplasty Today
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352344119300305

This study aimed to measure femoral head perfusion during hip resurfacing arthroplasty through a trochanter-sparing modified direct lateral approach. High-power laser Doppler probes were inserted into the femoral heads of 26 patients (26 hips, age range 35-70 years). Changes in blood flow were recorded (1) pre-capsulectomy (reference), (2) post-capsulectomy, and (3) following femoral head dislocation and reduction. There were no statistically significant changes in perfusion amplitudes post-capsulectomy and following femoral head dislocation and reduction (mean −10%, P = .134 and +27%, P = .166, respectively). Prolonged dislocation with the hip maximally flexed and externally rotated resulted in significantly decreased perfusion (mean −28%, P = .002). This study provides in vivo evidence that surgical hip dislocation is feasible using a modified direct lateral approach. Keywords: Surgical hip dislocation, Direct lateral approach, Hip, Hardinge, Femoral head blood supply