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Hydraulic resistance: A measure of vascular outflow obstruction in osteonecrosis
Author(s) -
Downey Daniel J.,
Simkin Peter A.,
Lanzer William L.,
Matsen Frederick A.
Publication year - 1988
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.1100060215
Subject(s) - cadaveric spasm , medicine , femoral head , outflow , femur , surgery , nuclear medicine , meteorology , physics
This study introduces hydraulic resistance (HR) as a new method to measure intraosseous vascular outflow resistance in the human proximal femur. HR is the standard measure of resistance to fluid flow in porous matrices and is derived from serial pressure/flow determinations. Eighteen hips were studied in 11 patients taken to surgery for core decompression therapy of presumable atraumatic osteonecrosis of the femoral head. HR was much higher in osteonecrotic (174 ± 29 mm Hg min/ml, SE) than in normal human cadaveric femora (14 ± 6) and was also higher in subcapital (253 ± 39) than intertrochanteric sites (78 ± 17). HR correlated highly with baseline intraosseous pressure (r = 0.74, p < 0.001). HR testing is a simple, practical method which quantifies outflow obstruction of the intraosseous circulation. We believe this test will be helpful in the diagnosis of atraumatic osteonecrosis and in the understanding of its underlying pathophysiology.