A response to ‘Sudden deaths during hip hemi‐arthroplasty’, Parry G, <i>Anaesthesia</i> 2003; 58: 922–23

Werner, Laura A.

doi:10.1111/j.1365-2044.2003.03622.x

Cited by 3 publications

(5 citation statements)

References 2 publications

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“…Numerous patient-related risk factors have been implicated in the genesis of BCIS including old age, 50 -52 poor preexisting physical reserve, 23 51 impaired cardiopulmonary function, 23 50 52 53 pre-existing pulmonary hypertension 69 osteoporosis, 50 51 bony metastases, 3 23 and concomitant hip fractures, 50 51 53 particularly pathological or intertrochanteric fractures. 50 These latter three factors are associated with increased 3 23 50 51 or abnormal 23 vascular channels through which marrow contents can migrate into the circulation.…”

Section: Patient Risk Factorsmentioning

confidence: 99%

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Bone cement implantation syndrome

Donaldson¹,

Thomson²,

Harper

et al. 2009

British Journal of Anaesthesia

459

435

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Bone cement implantation syndrome (BCIS) is poorly understood. It is an important cause of intraoperative mortality and morbidity in patients undergoing cemented hip arthroplasty and may also be seen in the postoperative period in a milder form causing hypoxia and confusion. Hip arthroplasty is becoming more common in an ageing population. The older patient may have co-existing pathologies which can increase the likelihood of developing BCIS. This article reviews the definition, incidence, clinical features, risk factors, aetiology, pathophysiology, risk reduction, and management of BCIS. It is possible to identify high risk groups of patients in which avoidable morbidity and mortality may be minimized by surgical selection for uncemented arthroplasty. Invasive anaesthetic monitoring should be considered during cemented arthroplasty in high risk patients.

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Section: Patient Risk Factorsmentioning

confidence: 99%

“…Mortality in the two groups was 2.8% and 13.8%, respectively. 69 Working the cement to remove the volatile vasodilatory compounds has also been recommended. 52 53 The 2006 British Orthopaedic Association Guide to Good Practice recommends a number of the above measures.…”

Section: Surgical Risk Reductionmentioning

confidence: 99%

Bone cement implantation syndrome

Donaldson¹,

Thomson²,

Harper

et al. 2009

British Journal of Anaesthesia

459

435

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“…Intramedullary lavage and good hemostasis before insertion was recommended. Use of vacuum mixing can significantly reduce cardiopulmonary complication rate compared to finger packing, likely because of removal of excessive volatile components [21] . Drill-hole venting of femoral cortex can also reduce BCIS risk but risk of femoral fracture exists.…”

Section: Discussionmentioning

confidence: 99%

Dangers with cementation under low-viscosity state: Cement arterio-venogram and bone cement implantation syndrome

Wan

Liu

et al. 2021

Trauma Case Reports

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Cement arterio-venogram is a rare event with cement extrusion into femoral nutrient vessels. In literature it is known to be benign with no significant clinical sequelae. It is postulated that it is due to high cement implantation pressure, that results in optimal cement filling quality. All previously reported cases were female patients, and it is thought to be a female only phenomenon due to the relatively narrow femoral canal leading to higher pressures during cementation. In this case series we report 3 cases different to existing literature. All 3 patients showed a cement arterio-venogram together with bone cement implantation syndrome and hypotension intraoperatively. It was also observed that during implantation the cement was of low viscosity. We postulate low cement viscosity during implantation with pressurization is also a contributing factor to these phenomena. This case series also demonstrates the first 2 male cases, showing this the even can occur in males too. The cement arteriovenogram is located at 41%–42% femur length which is within the ‘third sixth’ of the length of the femur. Good cementation techniques and prevention is also highlighted in this report.

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“…Method of cement mixing can have varying effects on cement properties: hand mixing has been shown to be inferior to vacuum in terms of increased porosity and decreased tensile fatigue strength, while being superior in regards to antibiotics elution compared to vacuum preparation . The increased porosity witnessed with hand‐mixing of bone cement leads to an increase in the antibiotic elution compared to the vacuum‐mixed less‐porous cement preparation Furthermore, this method of preparation increases complications and mortality rates, as one study reported a 13.8% rate of deaths associated with manual preparation, compared to a rate of 2.8% associated with vacuum preparation . The authors report a higher rate of pulmonary embolism, a decrease in arterial oxygenation and circulatory insufficiency in the hand‐mixed cohort when compared to the vacuum‐mixed group .…”

Section: Properties Of Cementmentioning

confidence: 99%

“…This increased pressure potentially leads to intraoperative death from embolic debris during cementation . However, the greatest impact on intramedullary pressure remains that of prosthesis insertion …”

Section: Properties Of Cementmentioning

confidence: 99%

Acrylic bone cement in total joint arthroplasty: A review

et al. 2016

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Acrylic bone cement has a variety of applications in orthopedic surgery. Primary uses in total arthroplasties are limited to prostheses fixation and antibiotic delivery. With the large number of total joint arthroplasties expected to continue to rise, understanding the role bone cement plays in the success of total joint arthroplasty can have a significant impact on daily practice. The literature is inconclusive on whether cemented or cementless fixation technique is superior, and choice of fixation type is mainly determined by surgeon preference and experience. Surgeons should understand that if poor techniques exist, short-term outcomes of the replaced joint may be at risk. Statement of clinical significance: This article attempts to clarify some points of bone cement use through a review of the mechanical properties related to bone cement, a comparison to alternative materials, influence of additives, and the effects on surgical outcomes. ß

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A response to ‘Sudden deaths during hip hemi‐arthroplasty’, Parry G, Anaesthesia 2003; 58: 922–23

Cited by 3 publications

References 2 publications

Bone cement implantation syndrome

Bone cement implantation syndrome

Dangers with cementation under low-viscosity state: Cement arterio-venogram and bone cement implantation syndrome

Acrylic bone cement in total joint arthroplasty: A review

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