Bone cement implantation syndrome in cemented hemiarthroplasty for femoral neck fracture: incidence, risk factors, and effect on outcome

Olsen, Fredrik; M, Kotyra; Houltz, Erik; Ricksten, Sven‐Erik

doi:10.1093/bja/aeu226

Cited by 166 publications

(208 citation statements)

References 23 publications

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“…Severe bone cement implantation syndrome has a substantial impact on early and late mortality (Olsen et al. 2014). Thus, the use of uncemented hydroxyapatite stems for this patient group may still be justified.…”

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confidence: 99%

More complications with uncemented than cemented femoral stems in total hip replacement for displaced femoral neck fractures in the elderly

et al. 2016

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Background and purposeTotal hip replacement (THR) is the preferred method for the active and lucid elderly patient with a displaced femoral neck fracture (FNF). Controversy still exists regarding the use of cemented or uncemented stems in these patients. We compared the effectiveness and safety between a modern cemented, and a modern uncemented hydroxyapatite-coated femoral stem in patients 65–79 years of age who were treated with THR for displaced FNF.Patients and methodsIn a single-center, single-blinded randomized controlled trial, we included 69 patients, mean age 75 (65–79) and with a displaced FNF (Garden III–IV). 35 patients were randomized to a cemented THR and 34 to a reverse-hybrid THR with an uncemented stem. Primary endpoints were: prevalence of all hip-related complications and health-related quality of life, evaluated with EuroQol-5D (EQ-5D) index up to 2 years after surgery. Secondary outcomes included: overall mortality, general medical complications, and hip function. The patients were followed up at 3, 12, and 24 months.ResultsAccording to the calculation of sample size, 140 patients would be required for the primary endpoints, but the study was stopped when only half of the sample size was included (n = 69). An interim analysis at that time showed that the total number of early hip-related complications was substantially higher in the uncemented group, 9 (among them, 3 dislocations and 4 periprosthetic fractures) as compared to 1 in the cemented group. The mortality and functional outcome scores were similar in the 2 groups.InterpretationWe do not recommend uncemented femoral stems for the treatment of elderly patients with displaced FNFs.

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More complications with uncemented than cemented femoral stems in total hip replacement for displaced femoral neck fractures in the elderly

et al. 2016

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“…BoneCement-Implantation-Syndrom (BCIS). Dabei handelt es sich um eine Zementreaktion, die beim Einbringen des Zements oder dem anschließenden Einsetzen der Prothese auftritt und sich durch Symptome wie Hypoxie, Hypotension, Herzrhythmusstörungen, erhöhten pulmonalen Gefäßwiderstand bis hin zum Herzstillstand äußert [9,28]. Es werden je nach Ausprägung 3 Schweregrade des BCIS unterschieden [9].…”

Section: Zementierte Versus Unzementierte Implantationunclassified

“…Es werden je nach Ausprägung 3 Schweregrade des BCIS unterschieden [9]. In den unterschiedlichen Ausprägungen sind bis zu 28 (within 24 h) after the trauma. In displaced fractures (Garden types III and IV) in geriatric patients implantation of a cemented prosthesis is recommended.…”

Section: Zementierte Versus Unzementierte Implantationunclassified

“…Femoral neck fracture · Hip fracture · Geriatric trauma · Geriatric fracture · Joint replacement gehen [28]. Als Ursache für das BCIS werden aktuell mehrere Theorien diskutiert, am ehesten scheinen zementassoziierte Embolien ursächlich, die einerseits mechanische Komplikationen verursachen und andererseits durch Mediatoraktivierung mit Freisetzung von vasoaktiven und proinflammatorischen Substanzen den pulmonalen Gefäßwiderstand erhö-hen [9].…”

Section: Introductionunclassified

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Hüftendoprothetik nach Trauma

Hack

Bücking

Eschbach

et al. 2017

Trauma Berufskrankh

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“…Predictive risk factors for BCIS identified by Olsen et al 9 include higher American Society of Anaesthesiologists (ASA) grades, chronic obstructive airway disease, diuretics and warfarin, while lower preoperative mobility status is associated with higher early venous thromboembolism rate following cemented hemiarthroplasty 11…”

Section: Introductionmentioning

confidence: 99%

Catastrophic cement reaction following cementation for megaprosthesis for proximal femoral fracture

Baig¹,

Callaghan

Murphy

2017

BMJ Case Reports

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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 proposed 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". Other features include increased vascular resistance, cardiac arrhythmias and cardiac arrest post cement use.We describe a case of a patient who suffered a catastrophic reaction to cement during surgery for a comminuted proximal femoral fracture.

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Bone cement implantation syndrome in cemented hemiarthroplasty for femoral neck fracture: incidence, risk factors, and effect on outcome

Abstract: BCIS is a commonly occurring phenomenon in cemented hemiarthroplasty and severe BCIS has a huge impact on early and late mortality.

Cited by 166 publications

References 23 publications

More complications with uncemented than cemented femoral stems in total hip replacement for displaced femoral neck fractures in the elderly

More complications with uncemented than cemented femoral stems in total hip replacement for displaced femoral neck fractures in the elderly

Hüftendoprothetik nach Trauma

Catastrophic cement reaction following cementation for megaprosthesis for proximal femoral fracture

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