Cerebral Fat Embolism Syndrome After Simultaneous Bilateral Total Knee Arthroplasty

Cerebral fat embolism syndrome following total knee replacement causing a devastating neurocognitive sequelae

“…The presentation varies from asymptomatic or with mild respiratory distress to a catastrophic clinical scenario with a triad of symptoms that include dyspnea, petechial hemorrhages of the skin, and confusion that may lead to coma or death. The FES is usually prevalent in 1-5% of patients following trauma to the pelvis and long bones and rarely described in elective orthopedic knee procedures 1. A 71-year-old male patient with controlled diabetes mellitus and hypertension was admitted to King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia for scheduled bilateral total knee replacement (TKR) in July 2014.…”

Fat Embolism Syndrome: An Autopsy-Proven Case Involving a Patient on Dialysis and Systemic Scleroderma

“…12 Based on the involvement of the respiratory system alone, Lideque et al added another criterion (Table 1). 13 There is currently no consensus on how to diagnose FES 14. In the present patient, hypoxia with PaO 2 less than 60 torr, the first major item in Gurd and Wilson’s criteria, was not met, since her PaO 2 was 67.7 torr.…”

Simultaneous-bilateral TKA

“…1 A higher incidence of fat embolism syndrome after a simultaneous bilateral TKA is another problem associated with a simultaneous bilateral procedure. 10,11 Although the overall incidence of fat embolism after a simultaneous bilateral TKA is as low as 0.17%, 11 it is higher than after a unilateral procedure and this point should be taken into account when the patients are scheduled for simultaneous bilateral TKA.…”