Skip to main content
Top
Published in: Journal of Orthopaedics and Traumatology 4/2010

Open Access 01-12-2010 | Original Article

Femoral-head vascularity after hip surface arthroplasty

Authors: Arun Kannan, Chandra Sekhar Bal, Vijay Kumar, Ravi Mittal, Nishikant Damle, Rajesh Malhotra

Published in: Journal of Orthopaedics and Traumatology | Issue 4/2010

Login to get access

Abstract

Background

Iatrogenic devascularization of the femoral head is as an area of concern following hip resurfacing arthroplasty, with probable implications on short-term failure and long-term survival of the implant.

Materials and methods

We assessed the vascularity of 25 resurfaced femoral heads in 20 patients by comparison with preoperative and postoperative Tc-99m methylene diphosphonate (MDP) bone scintigraphy images, the postoperative scans being done 9 months after the surgery.

Results

Eight out of 25 hips (32%) showed <55% of their preoperative uptake at a mean of 9 months after surgery and were categorized as showing reduced vascularity.

Conclusion

Our study reveals reduction in vascularity of the femoral-head remnant as a frequent occurrence after hip resurfacing. Our study also highlights the role of bone scintigraphy as tool in assessing the vascularity of resurfaced femoral heads.
Literature
1.
go back to reference Amstutz HC, Beaule PE, Dorey FJ, Le Duff MJ, Campbell PA, Gruen TA (2004) Metal-on-metal hybrid surface arthroplasty: two to six-year follow-up study. J Bone Joint Surg [Am] 86:28–39 Amstutz HC, Beaule PE, Dorey FJ, Le Duff MJ, Campbell PA, Gruen TA (2004) Metal-on-metal hybrid surface arthroplasty: two to six-year follow-up study. J Bone Joint Surg [Am] 86:28–39
2.
go back to reference Daniel J, Pynsent PB, McMinn DJ (2004) Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis. J Bone Joint Surg [Br] 86:177–184CrossRef Daniel J, Pynsent PB, McMinn DJ (2004) Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis. J Bone Joint Surg [Br] 86:177–184CrossRef
3.
go back to reference Treacy RB, McBryde CW, Pynsent PB (2005) Birmingham hip resurfacing arthroplasty. A minimum follow-up of five years. J Bone Joint Surg [Br] 87:167–170CrossRef Treacy RB, McBryde CW, Pynsent PB (2005) Birmingham hip resurfacing arthroplasty. A minimum follow-up of five years. J Bone Joint Surg [Br] 87:167–170CrossRef
4.
go back to reference Back DL, Dalziel R, Young D, Shimmin A (2005) Early results of primary Birmingham hip resurfacings. An independent prospective study of the first 230 hips. J Bone Joint Surg [Br] 87:324–329CrossRef Back DL, Dalziel R, Young D, Shimmin A (2005) Early results of primary Birmingham hip resurfacings. An independent prospective study of the first 230 hips. J Bone Joint Surg [Br] 87:324–329CrossRef
5.
go back to reference Nishii T, Sugano N, Miki H, Takao M, Koyama T, Yoshikawa H (2007) Five-year results of metal-on-metal resurfacing arthroplasty in Asian patients. J Arthroplasty 22:176PubMedCrossRef Nishii T, Sugano N, Miki H, Takao M, Koyama T, Yoshikawa H (2007) Five-year results of metal-on-metal resurfacing arthroplasty in Asian patients. J Arthroplasty 22:176PubMedCrossRef
6.
go back to reference Australian Orthopaedic Association (2007) National joint replacement registry annual report. AOA, Adelaide Australian Orthopaedic Association (2007) National joint replacement registry annual report. AOA, Adelaide
7.
go back to reference Crawford JR, Palmer SJ, Wimhurst JA, Villar RN (2005) Bone loss at hip resurfacing: a comparison with total hip arthroplasty. Hip Int 15:195–198 Crawford JR, Palmer SJ, Wimhurst JA, Villar RN (2005) Bone loss at hip resurfacing: a comparison with total hip arthroplasty. Hip Int 15:195–198
8.
go back to reference Vendittoli PA, Lavigne M, Girard J, Roy AG (2006) A randomised study comparing resection of acetabular bone at resurfacing and total hip replacement. J Bone Joint Surg [Br] 88:997–1002CrossRef Vendittoli PA, Lavigne M, Girard J, Roy AG (2006) A randomised study comparing resection of acetabular bone at resurfacing and total hip replacement. J Bone Joint Surg [Br] 88:997–1002CrossRef
9.
go back to reference Capello WN, Trancik TM, Misamore G, Eaton R (1982) Analysis of revision surgery of resurfacing hip arthroplasty. Clin Orthop Relat Res 170:50–55PubMed Capello WN, Trancik TM, Misamore G, Eaton R (1982) Analysis of revision surgery of resurfacing hip arthroplasty. Clin Orthop Relat Res 170:50–55PubMed
10.
go back to reference Ball ST, Le Duff MJ, Amstutz HC (2007) Early results of conversion of a failed femoral component in hip resurfacing arthroplasty. J Bone Joint Surg [Am] 89:735–741CrossRef Ball ST, Le Duff MJ, Amstutz HC (2007) Early results of conversion of a failed femoral component in hip resurfacing arthroplasty. J Bone Joint Surg [Am] 89:735–741CrossRef
11.
go back to reference Kishida Y, Sugano N, Nishii T, Miki H, Yamaguchi K, Yoshikawa H (2004) Preservation of the bone mineral density of the femur after surface replacement of the hip. J Bone Joint Surg [Br] 86:185–189CrossRef Kishida Y, Sugano N, Nishii T, Miki H, Yamaguchi K, Yoshikawa H (2004) Preservation of the bone mineral density of the femur after surface replacement of the hip. J Bone Joint Surg [Br] 86:185–189CrossRef
12.
go back to reference Girard J, Lavigne M, Vendittoli PA, Roy AG (2006) Biomechanical reconstruction of the hip: a randomised study comparing total hip resurfacing and total hip arthroplasty. J Bone Joint Surg [Br] 88:721–726CrossRef Girard J, Lavigne M, Vendittoli PA, Roy AG (2006) Biomechanical reconstruction of the hip: a randomised study comparing total hip resurfacing and total hip arthroplasty. J Bone Joint Surg [Br] 88:721–726CrossRef
13.
go back to reference Beaule PE, Le Duff M, Campbell P et al (2004) Metal-on-metal surface arthroplasty with a cemented femoral component: a 7–10 year follow-up study. J Arthroplasty 19(Suppl 3):17–22PubMed Beaule PE, Le Duff M, Campbell P et al (2004) Metal-on-metal surface arthroplasty with a cemented femoral component: a 7–10 year follow-up study. J Arthroplasty 19(Suppl 3):17–22PubMed
14.
go back to reference Pearson AM, Fognet P, Little C (2005) Can we prevent fractures in hip resurfacing? J Bone Joint Surg [Br] 87-B(Suppl 1):41 Pearson AM, Fognet P, Little C (2005) Can we prevent fractures in hip resurfacing? J Bone Joint Surg [Br] 87-B(Suppl 1):41
15.
go back to reference Shimmin AJ, Back D (2005) Femoral neck fractures following Birmingham hip resurfacing. J Bone Joint Surg [Br] 87-B:463–464CrossRef Shimmin AJ, Back D (2005) Femoral neck fractures following Birmingham hip resurfacing. J Bone Joint Surg [Br] 87-B:463–464CrossRef
16.
go back to reference Amstutz HC, Campbell PA, Le Duff MJ (2004) Fracture of the neck of the femur after surface arthroplasty of the hip. J Bone Joint Surg [Am] 86:1874–1877 Amstutz HC, Campbell PA, Le Duff MJ (2004) Fracture of the neck of the femur after surface arthroplasty of the hip. J Bone Joint Surg [Am] 86:1874–1877
17.
go back to reference Campbell P, Beaulé P, Ebramzadeh E, LeDuff M, Smet K, Lu Z, Amstutz HC (2006) A study of implant failure in metal-on-metal surface arthroplasties. Clin Orthop Relat Res 453:35–46PubMedCrossRef Campbell P, Beaulé P, Ebramzadeh E, LeDuff M, Smet K, Lu Z, Amstutz HC (2006) A study of implant failure in metal-on-metal surface arthroplasties. Clin Orthop Relat Res 453:35–46PubMedCrossRef
18.
go back to reference Shimmin AJ, Bare J, Back DL (2005) Complications associated with hip resurfacing arthroplasty. Orthop Clin North Am 36:187–193PubMedCrossRef Shimmin AJ, Bare J, Back DL (2005) Complications associated with hip resurfacing arthroplasty. Orthop Clin North Am 36:187–193PubMedCrossRef
19.
go back to reference Bradley GW, Freeman MA, Revell PA (1987) Resurfacing arthroplasty. Femoral head viability. Clin Orthop Relat Res 220:137–141PubMed Bradley GW, Freeman MA, Revell PA (1987) Resurfacing arthroplasty. Femoral head viability. Clin Orthop Relat Res 220:137–141PubMed
20.
go back to reference Howie DW, Cornish BL, Vernon-Roberts B (1993) The viability of the femoral head after resurfacing hip arthroplasty in humans. Clin Orthop Relat Res 291:171–184PubMed Howie DW, Cornish BL, Vernon-Roberts B (1993) The viability of the femoral head after resurfacing hip arthroplasty in humans. Clin Orthop Relat Res 291:171–184PubMed
21.
go back to reference Campbell P, Mirra J, Amstutz HC (2000) Viability of femoral heads treated with resurfacing arthroplasty. J Arthroplasty 15(1):120–122PubMedCrossRef Campbell P, Mirra J, Amstutz HC (2000) Viability of femoral heads treated with resurfacing arthroplasty. J Arthroplasty 15(1):120–122PubMedCrossRef
22.
go back to reference Little CP, Ruiz AL, Harding IJ, McLardy-Smith P, Gundle R, Murray DW, Athanasou NA (2005) Osteonecrosis in retrieved femoral heads after failed resurfacing arthroplasty in the hip. J Bone Joint Surg [Br] 87-B:320–323CrossRef Little CP, Ruiz AL, Harding IJ, McLardy-Smith P, Gundle R, Murray DW, Athanasou NA (2005) Osteonecrosis in retrieved femoral heads after failed resurfacing arthroplasty in the hip. J Bone Joint Surg [Br] 87-B:320–323CrossRef
23.
go back to reference Gawkrodger DJ (2003) Metal sensitivities and orthopaedic implants revisited: the potential for metal allergy with the new metal-on-metal joint prostheses. Br J Dermatol 148:1089–1093PubMedCrossRef Gawkrodger DJ (2003) Metal sensitivities and orthopaedic implants revisited: the potential for metal allergy with the new metal-on-metal joint prostheses. Br J Dermatol 148:1089–1093PubMedCrossRef
24.
go back to reference Hallab N, Merritt K, Jacobs JJ (2001) Metal sensitivity in patients with orthopaedic implants. J Bone Joint Surg [Am] 83:428–436CrossRef Hallab N, Merritt K, Jacobs JJ (2001) Metal sensitivity in patients with orthopaedic implants. J Bone Joint Surg [Am] 83:428–436CrossRef
25.
go back to reference Campbell P, Shimmin A, Walter L, Solomon M (2008) Metal sensitivity as a cause of groin pain in metal-on-metal hip resurfacing. J Arthroplasty 23(7):1080–1085PubMedCrossRef Campbell P, Shimmin A, Walter L, Solomon M (2008) Metal sensitivity as a cause of groin pain in metal-on-metal hip resurfacing. J Arthroplasty 23(7):1080–1085PubMedCrossRef
26.
go back to reference Storey G, Murray IPC (2004) Bone Scintigraphy: the procedure and interpretation. In: Ell PJ, Gambhir SS (eds) Nuclear Medicine in Clinical Diagnosis and Treatment, 3rd edn. Churchill Livingstone, New York, p 600 Storey G, Murray IPC (2004) Bone Scintigraphy: the procedure and interpretation. In: Ell PJ, Gambhir SS (eds) Nuclear Medicine in Clinical Diagnosis and Treatment, 3rd edn. Churchill Livingstone, New York, p 600
27.
go back to reference Lavigne M, Kalhor M, Beck M, Ganz R, Leunig M (2005) Distribution of vascular foramina around the femoral head and neck junction: relevance for conservative intracapsular procedures of the hip. Orthop Clin North Am 36:171–176PubMedCrossRef Lavigne M, Kalhor M, Beck M, Ganz R, Leunig M (2005) Distribution of vascular foramina around the femoral head and neck junction: relevance for conservative intracapsular procedures of the hip. Orthop Clin North Am 36:171–176PubMedCrossRef
28.
go back to reference Freeman MA (1978) Some anatomical and mechanical considerations relevant to the surface replacement of the femoral head. Clin Orthop Relat Res 134:19–24PubMed Freeman MA (1978) Some anatomical and mechanical considerations relevant to the surface replacement of the femoral head. Clin Orthop Relat Res 134:19–24PubMed
29.
go back to reference Steffen RT, Smith SR, Urban JP, McClardy-Smith P, Beard DJ, Gill HS, Murray DW (2005) The effect of hip resurfacing on oxygen concentration in the femoral head. J Bone Joint Surg [Br] 87:1468–1474CrossRef Steffen RT, Smith SR, Urban JP, McClardy-Smith P, Beard DJ, Gill HS, Murray DW (2005) The effect of hip resurfacing on oxygen concentration in the femoral head. J Bone Joint Surg [Br] 87:1468–1474CrossRef
30.
go back to reference Beaule PE, Campbell PA, Hoke R, Dorey FJ (2006) Notching of the femoral neck during resurfacing arthroplasty of the hip: a vascular study. J Bone Joint Surg [Br] 88:35–39CrossRef Beaule PE, Campbell PA, Hoke R, Dorey FJ (2006) Notching of the femoral neck during resurfacing arthroplasty of the hip: a vascular study. J Bone Joint Surg [Br] 88:35–39CrossRef
31.
go back to reference Beaulé PE, Campbell P, Shim P (2007) Femoral head blood flow during hip resurfacing. Clin Orthop Relat Res 456:148–152PubMedCrossRef Beaulé PE, Campbell P, Shim P (2007) Femoral head blood flow during hip resurfacing. Clin Orthop Relat Res 456:148–152PubMedCrossRef
32.
go back to reference Khan A, Yates A, Lovering A, Bannister GC, Spencer R (2007) The effect of surgical approach on blood flow to the femoral head during resurfacing. J Bone Joint Surg [Br] 89-B(1):21–25CrossRef Khan A, Yates A, Lovering A, Bannister GC, Spencer R (2007) The effect of surgical approach on blood flow to the femoral head during resurfacing. J Bone Joint Surg [Br] 89-B(1):21–25CrossRef
33.
go back to reference Amarasekera HW, Costa ML, Foguet P, Krikler SJ, Prakash U, Griffin DR (2008) 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 90(4):442–445PubMedCrossRef Amarasekera HW, Costa ML, Foguet P, Krikler SJ, Prakash U, Griffin DR (2008) 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 90(4):442–445PubMedCrossRef
34.
go back to reference McMahon SJ, Young D, Ballok Z, Badaruddin BS, Larbpaiboonpong V, Hawdon G (2006) Vascularity of the Femoral Head After Birmingham Hip Resurfacing. A Technetium Tc 99m Bone Scan/Single Photon Emission Computed Tomography Study. J Arthroplasty 21(4):514–521PubMedCrossRef McMahon SJ, Young D, Ballok Z, Badaruddin BS, Larbpaiboonpong V, Hawdon G (2006) Vascularity of the Femoral Head After Birmingham Hip Resurfacing. A Technetium Tc 99m Bone Scan/Single Photon Emission Computed Tomography Study. J Arthroplasty 21(4):514–521PubMedCrossRef
35.
go back to reference Forrest N, Welch A, Murray AD, Schweiger L, Hutchison J, Ashcroft GP (2006) Femoral head viability after birmingham resurfacing hip arthroplasty: assessment with use of [18F] fluoride positron emission tomography. J Bone Joint Surg [Am] 88:84–89CrossRef Forrest N, Welch A, Murray AD, Schweiger L, Hutchison J, Ashcroft GP (2006) Femoral head viability after birmingham resurfacing hip arthroplasty: assessment with use of [18F] fluoride positron emission tomography. J Bone Joint Surg [Am] 88:84–89CrossRef
36.
go back to reference Utz JA, Lull RJ, Calvin EC (1986) Asymptomatic total hip prosthesis: natural history determined using Tc-99m mdp bone scans. Radiology 161:509–512PubMedCrossRef Utz JA, Lull RJ, Calvin EC (1986) Asymptomatic total hip prosthesis: natural history determined using Tc-99m mdp bone scans. Radiology 161:509–512PubMedCrossRef
38.
go back to reference Bhan S, Pankaj A, Malhotra R (2006) One or two stage bilateral total hip arthroplasty: a prospective, randomised, controlled study in an Asian population. J Bone Joint Surg Br 88(3):298–303PubMedCrossRef Bhan S, Pankaj A, Malhotra R (2006) One or two stage bilateral total hip arthroplasty: a prospective, randomised, controlled study in an Asian population. J Bone Joint Surg Br 88(3):298–303PubMedCrossRef
39.
go back to reference Dhaon BK, Nigam V, Jaiswal A, Jain V (2005) Clinical and radiological evaluation of hybrid hip replacement in various disorders of hip. Indian J Orthop 39:90–92CrossRef Dhaon BK, Nigam V, Jaiswal A, Jain V (2005) Clinical and radiological evaluation of hybrid hip replacement in various disorders of hip. Indian J Orthop 39:90–92CrossRef
40.
go back to reference Dhaon BK, Nigam V, Jaiswal A, Jain V (2005) Noncemented total hip replacement in various disorders of hip. Indian J Orthop 39:225–227CrossRef Dhaon BK, Nigam V, Jaiswal A, Jain V (2005) Noncemented total hip replacement in various disorders of hip. Indian J Orthop 39:225–227CrossRef
41.
go back to reference Mitchell DC, Rao VM, Dalinka MK, Spritzer CE, Alavi A, Fallon M, Kressel HY (1987) Femoral head avascular necrosis: correlation of mr imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology 162:709–715PubMedCrossRef Mitchell DC, Rao VM, Dalinka MK, Spritzer CE, Alavi A, Fallon M, Kressel HY (1987) Femoral head avascular necrosis: correlation of mr imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology 162:709–715PubMedCrossRef
Metadata
Title
Femoral-head vascularity after hip surface arthroplasty
Authors
Arun Kannan
Chandra Sekhar Bal
Vijay Kumar
Ravi Mittal
Nishikant Damle
Rajesh Malhotra
Publication date
01-12-2010
Publisher
Springer International Publishing
Published in
Journal of Orthopaedics and Traumatology / Issue 4/2010
Print ISSN: 1590-9921
Electronic ISSN: 1590-9999
DOI
https://doi.org/10.1007/s10195-010-0107-x

Other articles of this Issue 4/2010

Journal of Orthopaedics and Traumatology 4/2010 Go to the issue

Acknowledgement to Referees

2010 Scientific Referees