Immediate effect of osteotomy on the intramedullary pressure in the femoral head and neck in patients with degenerative osteoarthritis.

Abstract

Recently, Arnoldi, Linderholm & Miissbichler (1971, and to be published) demonstrated a considerable hypertension in the cancellous bone marrow of the proximal part of the femur in patients with advanced stages of coxarthrosis. Simultaneous examinations by means of intraosseous phlebography indicated that the high pressure was accompanied by impaired venous drainage from the femoral head and neck. There are indications that intramedullary hypertension may be a causative factor for the aching rest pains typical of these patients. Therefore we have thought it of interest to investigate the effect upon intramedullary pressure of two operative procedures routinely performed for painful conditions in osteoarthritis of the hip. In both procedures the medullary space is opened and drained, in osteotomy, in the subtrochanteric region, in Smith Petersen cup arthroplasty by removal of bone and cartilage from the femoral head. In the present study the immediate effect of both procedures upon the intramedullary pressure was tested. MATERIAL Two groups of patients with degenerative osteoarthritis of the hip joint were examined. The first group consisted of seven patients treated by means of intcrtrochanteric osteotomy. In the second group, containing eight patients, Smith Petersen cup This work was supported by the Swedish Medical Research Council (Project No.