Correlation between shape-closed femoral stem design and bone cement implantation syndrome in osteoporotic elderly femoral neck fracture undergoing cemented hip arthroplasty: A retrospective case-control study in 128 patients

Chulsomlee, Kulapat; Prukviwat, Sasichol; Tuntiyatorn, Panithan; Vasaruchapong, Satetha; Kulachote, Noratep; Sirisreetreeux, Norachart; Tanphiriyakun, Thiraphat; Chanplakorn, Pongsthorn; Sa-ngasoongsong, Paphon

doi:10.1016/j.otsr.2022.103450

Cited by 4 publications

(1 citation statement)

References 28 publications

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“…One strategy is to use, from the beginning, an uncemented implant as some modern designs present a lower incidence of periprosthetic fracture and are more suitable for poor bone stock [ 46 ]. It was demonstrated that long and shape-closed design femoral components along with primary arthroplasties where the intramedullary canal was not yet reamed are additional contributing factors [ 47 , 48 , 49 ]. Other preventive surgical techniques include proper lavage of the intramedullary canal in order to remove debris, achieving hemostasis, and drilling a venting hole in the distal femoral shaft in order to minimize pressure and air entrapping when the stem is inserted [ 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

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

Moldovan

2023

JPM

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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.

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