Document Detail


Patellar blood flow during knee arthroplasty surgical exposure: Intraoperative monitoring by laser doppler flowmetry.
MedLine Citation:
PMID:  17549707     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patellofemoral complications following knee arthroplasty are a well-known problem. Patellar ischemia has been suspected to be causative for fracture, anterior knee pain, and patella component failure. The purpose of this study was to assess the influence of knee arthroplasty surgical dissection on patellar blood flow. Patellar blood flow was measured by means of intraosseous laser Doppler flowmetry (LDF) in 10 patients undergoing total knee arthroplasty by a standard medial parapatellar approach. The initial blood flow was 121.6 +/- 114.7 AU. The signal significantly decreased by 71% (p = 0.0051) when the knee was flexed and lost the pulsatile signal pattern in 80%. After arthrotomy, the signal was 100.1 +/- 120.3 AU in extension. The lowest signal was found in flexion and eversion of the patella (mean, 18 +/- 10.7 AU) and all signals lost pulsatility. As compared to the initial values, completion of the soft tissue dissection did not lead to a significant change of the blood flow signal (121.3 +/- 104.8; p = 0.6835). Flexion of the knee joint markedly reduced patellar perfusion. Standard medial parapatellar approach did not significantly change patellar blood flow. This study does not support the theory of postoperative patellar ischemia as a cause of anterior knee pain or patellofemoral problems.
Authors:
Axel Hempfing; Ralf Schoeniger; Peter P Koch; Oliver Bischel; Marc Thomsen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of orthopaedic research : official publication of the Orthopaedic Research Society     Volume:  25     ISSN:  0736-0266     ISO Abbreviation:  J. Orthop. Res.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-19     Completed Date:  2007-10-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8404726     Medline TA:  J Orthop Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1389-94     Citation Subset:  IM    
Affiliation:
University of Heidelberg, Orthopaedic Department, Schlierbacher Landstr. 200a, 69118 Schlierbach-Ziegelhausen, Germany. axel@hempfing.de
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MeSH Terms
Descriptor/Qualifier:
Arthroplasty, Replacement, Knee* / adverse effects
Dissection
Female
Humans
Ischemia / etiology
Laser-Doppler Flowmetry / methods*
Male
Microcirculation
Middle Aged
Monitoring, Intraoperative / instrumentation,  methods*
Patella / blood supply*
Postoperative Complications / etiology
Regional Blood Flow*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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