Effect of Bone Cement Implantation on Haemodynamics in Elderly Patients and Preventive Measure in Cemented Hemiarthroplasty

Abstract

This study was to investigate the influence of bone cement implantation on haemodynamics and the preventive effect of epinephrine hydrochloride on pulmonary embolism in elderly patients with cemented semihip replacement. 128 patients were retrospectively analyzed. The patients were treated with (group A, 64 cases) or without (group B, 64 cases) epinephrine hydrochloride saline. The monitoring indicators included systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation (SPO2). The indicators of the two groups were compared before and 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10 minutes after bone cement implantation. Analysis of variance and SNK-q test were used for the statistical analysis. Blood pressure and SPO2 of group B decreased with statistical difference (P < 0.05) and HR increased without statistical significance, comparing with those of group A. In group A, SBP, DBP, MAP, HR, and SPO2 after bone cement implantation did not change significantly at each time point comparing with before implantation (P > 0.05). Bone cement implantation has significant influence on hemodynamics in elderly patients with hemiarthroplasty. Flushing the bone marrow cavity with saline epinephrine hydrochloride is an effective measure to reduce the incidence of bone cement pulmonary embolism.

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note

“…Second, another difficulty is achieving initial stability. Although the use of a cemented stem has been proposed to solve this problem 20 21 22) , this is limitedly used because of a high mortality risk caused by fat embolism, cement embolism, vasodilation due to autonomic reflex and others in elderly patients with cardiovascular diseases 23) . We ensured solid fixation by using a cementless, double tapered, rectangular wedge-shaped, straight stem (Bencox®), and obtained excellent clinical and radiographic results at 2-year follow up 24 25) .…”

Comparison of haemodynamic parameters in two different geriatric age groups undergoing cemented bipolar hemiarthroplasty

“…Xiangbi et al, found significant decrease in saturation after cement implantation in the group where the medullary cavity was not flushed with epinephrine. 21 Le Font et al, on the contrary had no desaturation inspite of observing echogenic material traversing the RA and RV on TEE. 20 Two of the patients who desaturated had COPD(Chronic obstructive airway disease)and the other 2 had Bronchial Asthma(BA).…”

“…14 Xiangbi et al, found significant decrease in blood pressure(SBP and DBP) 1min after cement implantation in the group where the medullary cavity was not flushed with epinephrine. 21 Above differences in various studies may be explained by differences in the surgical techniques and the cardiopulmonary reserve of the patients.…”

Cementless total hip arthroplasty for failed treatment of subtrochanteric fracture

“…Cement extravasation due to previous screw holes leads to a weak cement mantle, which is visible from postoperative radiographs [22]. Besides, cement may also elevate cardiovascular risk in elderly patients [23]. For the femoral side, because the previously failed xation device causes bone sclerosis and absence of the femoral metaphyseal, it is di cult to anchor in the cortex for the cemented femoral implant.…”