Summary
In 18 patients who underwent total hip replacement, the intramedullary pressure in the femur was measured during the insertion of the femoral prosthesis component. Half the patients had a pressure release hole (diameter 4.5 mm) drilled into the medullary canal at the distal end of the femur, the other half not. In the patients without a venting hole, the intramedullary pressure increased transiently to a median of 390mm Hg during the insertion of the femoral stem, while those with a venting hole only showed an increase to 23 mm Hg. A drop in arterial oxygen tension of 2.2kPa and in thrombocytes of 51 × 109/1 was found in those without a venting hole, while the corresponding values in those with a venting hole were 0.9kPa and 20 × 109/1. Furthermore, a significant correlation was demonstrated between the increase in intramedullary pressure and the drop in oxygen tension and in blood platelets. No significant change in blood pressure was measured during operation in either group.
Zusammenfassung
Bei 18 Patienten, die einen totalen Hüftgelenkersatz erhielten, wurde der intramedulläre Druck im Femur während des Einsetzens der femoralen Prothesenkomponente gemessen. Bei der Hälfte der Patienten war im distalen Femur ein Druckentlastungsloch von 4,5 mm Durchmesser gebohrt worden. Beim Einsetzen des Prothesenschaftes kam es bei den Patienten ohne Entlastungsloch zu einem vorübergehenden Anstieg des intramedullären Druckes bis zu einem Medianwert von 390mmHg, während mit dem Entlastungsloch die Drucksteigerung nur 23mmHg betrug. Ohne Entlastungsloch wurde ein Absinken des arteriellen Sauerstoff-Partialdrucks von 2,2kPa and der Thrombocyten von 51 × 109/1gefunden,miteinemEntlastungsloch betrugen these Werte 0,9kPa bzw. 20 × 109/1. Ferner wurde eine signifikante Korrelation zwischen der Steigerung des intramedullaren Drucks and dem Abfall des Sauerstoff-Partialdruckes and der Thrombocytenzahl gezeigt. Eine signifikante Veränderung des Blutdrucks während der Operation wurde bei keiner der beiden Gruppen gemessen.
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Engesæter, L.B., Strand, T., Raugstad, T.S. et al. Effects of a distal venting hole in the femur during total hip replacement. Arch. Orth. Traum. Surg. 103, 328–331 (1984). https://doi.org/10.1007/BF00432420
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DOI: https://doi.org/10.1007/BF00432420