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TOTAL HIP REPLACEMENT has become a frequent procedure since the initial work of Charnley, McKee, Watson, Ferrar and Ring in the early 1960s. The most popular technique, that of Miiller, ~ involves a socket prosthesis fixed in the acetabulum with acrylic bone cement. A femoral prosthesis is then fixed in the medullary cavity with the same acrylic cement. Peroperative complications associated with prosthesis implantation have ranged from transient hypotension, 8 cardiac arrest, 4 and embolic phenomena TM to significant decreases in arterial oxygen tension, s,9 This study is an attempt to review the clinical management of these patients with particular attention to their needs during operation. An attempt is also made to assess the significance of variations of the cardiovascular and pulmonary gas exchange which are associated with the use of acrylic bone cement. Alveolararterial oxygen gradients (A-aDO2), arterio-alveolar carbon dioxide gradients (a-ADCO2), and venous admixture (Qs/Qt) are used to assess these variations.

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