Bone Cement Implantation Syndrome: A Rare Disaster Following Cemented Hip Arthroplasties—Clinical Considerations Supported by Case Studies

Abstract

Severe symptoms such as hypoxemia, hypotension, and unexpected loss of consciousness may develop during surgical interventions that use polymethyl methacrylate (PMMA), or as it is commonly known, bone cement. Physicians recognize this amalgam of clinical manifestations more and more as a distinct entity that bears the name of bone cement implantation syndrome (BCIS). Trauma cases, especially hip fractures, are seen to have a higher incidence of developing this complication compared to orthopedic elective ones. This research aims to present a detailed description of six severe BCIS cases in order to raise awareness and to emphasize its importance. Five of them had fatal outcomes, which demonstrate the necessity of future research on this topic, as little is known about it presently. In the Discussion section, a narrative overview from the scientific literature is performed on potential risk factors, prevention measures, and management strategies. The experience gathered through this case series may aid medical staff in the development of diagnostic and therapeutic protocols, thus improving safety when cemented surgical techniques are used on a high-risk group of patients.

Sterile Inflammatory Response and Surgery-Related Trauma in Elderly Patients with Subtrochanteric Fractures

“…As reported in the recent scientific literature, there seems to be an expanding role in the field of Orthopedics and Traumatology for these inflammatory markers in predicting mortality after hip fracture surgeries [27,28], determination of postoperative pain after arthroplasties [29], and comparing the invasiveness of two type of implants [26,30]. The present research analyzes through the proposed indexes the implications of a commonly met situation during non-elective orthopedic interventions, where the fracture site needs to be exposed to perform a qualitative reduction.…”

Prognostic Significance of Heart Failure in Acute Pulmonary Embolism: A Comprehensive Assessment of 30-Day Outcomes

“…Among the strengths of this study, this is the first study that provides a comprehensive assessment of the risk of early complications in patients with a history of HF following symptomatic acute PE. The combined perspective on these risks provides a more complete understanding of the clinical implications in this specific population and underscores the necessity of recognizing HF and reduced LVEF as potential complicating factors in the management of acute PE; these findings suggest that clinicians should adopt tailored early-management strategies and follow-up-care protocols for improved outcomes [ 43 , 44 ]. The results significantly reinforce the prognostic importance of HF in relation to early complications after symptomatic acute PE and contribute to the clinical understanding of the evolution of patients with this combination of medical conditions.…”

Assessment of Cement Leakage in Decompressed Percutaneous Kyphoplasty

“…No significant complications were noted in either patient group, which might be linked to the limited participant pool. However, it is crucial to acknowledge the potential occurrence of rare complications, such as cement implantation syndrome, as discussed in a prior study [58]. Conducting a more extensive study with a larger participant cohort is essential to substantiate the effect of decompressed kyphoplasty on these complications.…”