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Bone cement implantation syndrome

Kai B Kaufmann, Wolfgang Baar, Judith Rexer, Thomas Loeffler, Sebastian Heinrich, Lukas Konstantinidis, Hartmut Buerkle, Ulrich Goebel
BACKGROUND: The bone cement implantation syndrome (BCIS) is a frequent and potentially disastrous intraoperative complication in patients undergoing cemented hip arthroplasty. Several risk factors have been identified, however randomized controlled trials to reduce the incidence of BCIS are still pending. We hypothesized that goal-directed hemodynamic therapy guided by esophageal Doppler monitoring (EDM) may reduce the incidence of BCIS in a randomized, controlled parallel-arm trial. METHODS: After approval of the local ethics committee, 90 patients scheduled for cemented hip arthroplasty at the Medical Center - University of Freiburg were randomly assigned to either standard hemodynamic management or goal-directed therapy (GDT) guided by an esophageal Doppler monitoring-based algorithm...
June 6, 2018: BMC Anesthesiology
Method Kabelitz, Yannick Fritz, Patrick Grueninger, Christoph Meier, Patrick Fries, Michael Dietrich
Background: Subsidence of cementless femoral stems in hemiarthroplasty (HA) and increased fracture rates are ongoing concerns of orthopedic surgeons when treating fractures in very old patients. Additionally, bone cement implantation syndrome may result in perioperative cardiac or pulmonary complications, especially in older patients, leading to morbidity and mortality. This study was performed to analyze possible subsidence and intraoperative fractures in a cohort of very old patients treated with cementless stems...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Theodosios Saranteas, Andreas F Mavrogenis, John Poularas, Andreas Kostroglou, Christina Mandila, Fotios Panou
Venous thromboembolism (deep vein thrombosis and pulmonary embolism) and bone cement implantation syndrome are major sources of embolic events in trauma patients. In these patients, embolic events due to venous thromboembolism and bone cement implantation syndrome have been detected with cardiac and vascular ultrasonography in the emergency setting, during the perioperative period, and in the intensive care unit. This article discusses the ultrasonography modalities and imaging findings of embolic events related to venous thromboembolism and bone cement implantation syndrome...
June 2018: Journal of Critical Care
Pawan Kumar Hamal, Puspa Raj Poudel, Janith Singh
BACKGROUND: Bone cement implantation syndrome is a known complication causing mortality during perioperative period particularly in patients with malignancy. With rise in aging population with malignancy in low income country, the syndrome is more likely to be encountered. CASE PRESENTATION: We present a case of 66 years old male patient with metastatic bronchogenic carcinoma of lung with pathological proximal femur fracture of left hip that underwent a cemented endoprosthesis under combined spinal epidural anesthesia who succumbed to intraoperative mortality due to grade III bone cement implantation syndrome even after aggressive fluid resuscitation, vasopressor use, and mechanical ventilation...
March 2, 2018: BMC Anesthesiology
G Manoharan, B D Chatterton, T S Moores, P J Roberts
BACKGROUND: Guidelines on the management of displaced intracapsular fractures recommend using an Orthopaedic Data Evaluation Panel-rated cemented implant. Prior to the National Institute for Health and Care Excellence guidelines, uncemented implants were commonly used in the UK. METHODS: We retrospectively examined the outcomes of patients with uncemented Thompson's hemiarthroplasties at our unit, between April 2005 and December 2010. Patients who underwent revision surgery before December 2011 were identified...
February 8, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
M Mordà, S Pini, F Celli, F Casella, P Parchi, N Piolanti, S Marchetti, M Scaglione
Bone cement implantation syndrome (BCIS) is a rare form of intraoperative pulmonary embolism (EP) that occurs during cementation. It can be explained by two main theories: the monomer mediated model and the mechanic model. Our goal is to evaluate thromboelastographic changes in patients undergoing surgery for femoral neck fractures. We recruited 32 patients with a femoral neck fracture. The average age was 81.91 years (range 62-95). The patients were divided in two different groups: cemented hip arthroplasty (CC, 13 patients) and other surgical non-cemented techniques (SC, non-cemented hip arthroplasty, osteosynthesis)...
October 2017: Journal of Biological Regulators and Homeostatic Agents
Muhammad Nouman Baig, William Curtin, Michael Andrew Callaghan, Colin G Murphy
Bone cement implantation syndrome (BCIS) is a well-described and potentially fatal complication of orthopaedic surgery involving pressurised bone cement. Although also described for certain spinal procedures, it is most commonly associated with cemented hip and knee arthroplasty and with cemented hemiarthroplasty following neck of femur fracture in particular.Donaldson et alproposed the definition of BCIS as a syndrome "characterized by hypoxia, hypotension or both and/or unexpected loss of consciousness occurring around the time of cementation, prosthesis insertion, reduction of the joint or, occasionally, limb tourniquet deflation in a patient undergoing cemented bone surgery"...
September 23, 2017: BMJ Case Reports
Brett Rocos, Michael R Whitehouse, Michael B Kelly
To evaluate the evidence for the resuscitation of patients with hip fracture in the preoperative or perioperative phase of their treatment and its impact on mortality. DESIGN: We searched MEDLINE, EMBASE, CENTRAL and PROSPERO databases using a systematic search strategy for randomised trials and observational studies investigating the fluid resuscitation of any patient with hip fracture. No language limits were applied to the search, which was complemented by manually screening the reference lists of appropriate studies...
May 4, 2017: BMJ Open
Y S Prashanth, M Niranjan
INTRODUCTION: There is evidence for use of cemented hemiarthroplasty resulting in greater anchoring and lesser peri prosthetic fracture. However, this procedure results in more haemodynamic instability and cardiopulmonary complications termed as 'cement reaction' or bone cement implantation syndrome. There has been a heightened interest among surgeons to compare cemented and uncemented hemiarthroplasty for fracture neck of femur. AIM: To compare cemented and uncemented hemiarthroplasty in terms of blood loss during the procedure, post-operative complications, mortality, functional recovery and long term clinical outcome...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
Kshitij Chatterjee, Penchala S Mittadodla, Clinton Colaco, Rajani Jagana
With the increasing longevity of the population, the annual rates of hip arthroplasties performed have been steadily increasing over the past decade. Given the presence of medical comorbidities in the older patients, the peri-operative care of these individuals requires multi-specialty care, now more than ever. Hip arthroplasty is generally well tolerated, with early mortality after the procedure being <1%. Bone cement implantation syndrome (BCIS) is an entity that is occasionally encountered during or after the surgery...
February 2017: Indian Journal of Critical Care Medicine
Anita Ten Hagen, Pieter Doldersum, Tom van Raaij
BACKGROUND: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). CASE PRESENTATION: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation...
2016: Patient Safety in Surgery
Qian Chen, Chun Huang, Ya-Jun Zhang
The aim of the study was to assess the effect of commonly used intravertebral anesthesia on bone cement implantation syndrome (BCIS) in aged patients undergoing hemiarthroplasty.The medical records of 1210 aged patients receiving hemiarthroplasty under intravertebral anesthesia were retrospectively reviewed. Anesthesia charts for all patients were reviewed for central venous pressure, mean arterial pressure, arterial oxygen saturation, and heart rate before, during, and after cementation. Each patient was classified into no BCIS (grade 0) or BCIS grade 1, 2, or 3 according to the degree of hypotension, arterial desaturation, or loss of consciousness around cementation...
September 2016: Medicine (Baltimore)
Vikash Singh, Pradipta Bhakta, Edyta Zietak, Ashfaq Hussain
Bone cement implantation syndrome (BCIS) is a well-known entity but is poorly understood and rarely reported. It is an important cause of perioperative morbidity and mortality in the patient undergoing cemented hip arthroplasty. BCIS is characterized by hypotension, hypoxia, cardiac arrhythmias, and increased pulmonary vascular resistance and can lead to eventual cardiac arrest if not managed properly. We hereby report a case of delayed presentation of BCIS following cemented right hip arthroplasty.
June 2016: Journal of Clinical Anesthesia
J Bayón, M Sántas-Alvarez, R Ríos-Gómez, C González-Juanatey
No abstract text is available yet for this article.
August 2016: Revista Española de Anestesiología y Reanimación
Paolo Mazzola, Domenico Picone, Alessandra Anzuini, Maurizio Corsi, Giuseppe Bellelli, Giorgio Annoni
INTRODUCTION: Takotsubo cardiomyopathy is a syndrome characterized by transient cardiac ischemia-like symptoms, such as chest pain, increase of myocardial necrosis markers, electrocardiographic changes, and temporary left ventricular apical ballooning without significant coronary artery disease, often triggered by a particularly stressful situation. The association between Takotsubo and hip fracture surgery has been rarely reported in the literature. PRESENTATION OF CASE: An 81-year-old woman was hospitalized with a diagnosis of right femoral neck fracture...
2016: International Journal of Surgery Case Reports
Wangang Guo, Qiangsun Zheng, Bingling Li, Xiaoqin Shi, Dingcheng Xiang, Chen Wang
BACKGROUND: Inferior vena cava filters (IVCF) are frequently used for preventing pulmonary embolism (PE) following deep venous thromboembolism. OBJECTIVES: The present study was designed to investigate whether IVCF could prevent or impede the occurrence of bone cement implantation syndrome (BCIS), since PE is considered as the central mechanism of BCIS. MATERIALS AND METHODS: Fifteen sheep were divided into three groups: bone cement free (BCF) group, cement implantation (CI) group and IVCF group...
July 2015: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
Sigmar Schnutenhaus, Ralph G Luthardt, Heike Rudolph, Werner Götz
OBJECTIVES: Cleidocranial dysplasia (CCD) is a rare congenital malformation syndrome, inherited autosomal-dominantly. During a course of treatment including surgical, implantological and restorative procedures, an opportunity arose to histologically examine biopsies of the maxilla and mandible of a CCD patient 47 years of age. CASE REPORT: The aim of this case report is to present the results of the histological evaluation of the alveolar bone and the surgical pretreatment for and placement of six implants each in the maxilla and the mandible...
2015: International Journal of Clinical and Experimental Pathology
Hye Jin Park, Hyoseok Kang, Jae-Woo Lee, Seung Min Baek, Jeong Seung Seo
BACKGROUND: The old age population, including the very old aged (≥ 85 years), is rapidly increasing, and femur neck fracture from accidents is commonly seen in the elderly. Use of bone cement during bipolar hemiarthroplasty can cause bone cement implantation syndrome. METHODS: This study was prospectively conducted on the elderly who were scheduled to undergo elective cemented bipolar hemiarthroplasty under spinal anesthesia. Patients were divided into 2 groups: the old age (65-84 years) and very old age groups (≥ 85 years)...
February 2015: Korean Journal of Anesthesiology
Hiroshi Fujita, Tomoo Okumura, Hiroaki Hara, Hiroshi Toda, Hideto Harada, Ryuuichi Nishimura, Tomohiro Tominaga
BACKGROUND: Cement implantation syndrome, which is characterized by hypotension, hypoxemia, and cardiac arrhythmia or arrest, has been reported in the literature. The purpose of the present study was to monitor the blood pressure changes that occur after cementing during primary total hip arthroplasty (THA). METHODS: The present study examined 178 cases in which 204 joints were treated with primary THA. Study subjects had a mean age at the time of surgery of 64...
March 2015: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Mehran Soleimanha, Abbas Sedighinejad, Mohammad Haghighi, Bahram Naderi Nabi, Ahmad Reza Mirbolook, Mohsen Mardani-Kivi
BACKGROUND: Patients undergoing cemented hip hemiarthroplasty may develop bone cement implantation syndrome (BCIS) which is a leading cause of intraoperative complications. The purpose of this study was to evaluate cardiovascular changes during cemented hip hemiarthroplasty in elderly patients. METHODS: Cemented hip hemiarthroplasty was performed on 72 patients with femoral neck fracture. All patients were catheterized with a radial artery catheter to assess mean arterial pressure (MAP) and arterial blood gas (ABG) in these time points: just before cementation, just after cementation (0th), 5 min (5th) and 10 min (10th) after cementation, and at the end of surgery (END)...
September 2014: Archives of Bone and Joint Surgery
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