Institution: The University of Oxford
Investigators: Dr Richie Gill, Professor David Murray
Stream: PhD
Topic: Lower Limbs/Surgical Technique (Hip)
Status: Completed
The most commonly used approach for resurfacing surgery is the extended posterior approach, which provides good visibility for both the acetabular and femoral component preparation and implantation. However, several authors report this approach leads to compromise of the femoral head and neck blood supply. The main blood supply to the head and neck is from the deep branch of the medial femoral circumflex artery (MFCA).
During resurfacing through the extended posterior approach, the branches of the MFCA passing along the short external rotators to the femoral head are destroyed. The aim of this study was to develop further a technique for measuring intra-operatively oxygenation levels in the femoral head and neck during hip resurfacing surgery; and then examine differences between the posterior, anterolateral and trochanteric flip approaches. This study resulted in the development of a more robust and repeatable oxygen probe. Less reduction in oxygenation occurred during the anterolateral and the trochanteric flip approaches than authors' previously measured posterior approach cases. With the anterolateral and the trochanteric flip approaches the oxygen levels recovered after the reduction of the hip, suggesting that the blood supply was preserved.
The reduction in oxygenation during surgery in these cases was probably due to obstruction of the MFCA due to leg positioning. A modified posterior approach was examined which appeared more blood supply conserving than the traditional extended posterior approach. This project has been successfully concluded and has resulted in 2 peer-reviewed publications and 4 presentations at international meetings.
« Back to research projects
