Eleven patients who had a femoral component inserted with cement and
twenty-three who had a femoral component inserted without cement were
studied prospectively for changes in the pulmonary shunt associated with
total hip replacement. The levels of oxygen in the arterial blood and the
platelet counts were measured preoperatively and each morning for three
days after the arthroplasty. Levels of oxygen in the arterial blood were
determined intraoperatively, once before and once after the femoral
component was inserted. Intraoperative shunt values increased 28 per cent
when a femoral component was inserted with cement (p < 0.05), but they
did not change when cement was not used. The average postoperative shunt
values were higher than the average preoperative shunt values for both
groups of patients, but only the values on the second postoperative day
after a procedure with cement were significantly higher (p < 0.05). The
ability of the patient to tolerate an increase in pulmonary shunt should be
assessed when the femoral component is to be cemented during total hip
replacement.