Pulmonary haemodynamics and right ventricular function during cemented hemiarthroplasty for femoral neck fracture

Abstract

Cemented hemiarthroplasty in patients with femoral neck fracture causes a pronounced pulmonary vasoconstriction and an impairment of RV function accompanied by pulmonary ventilation/perfusion abnormalities.

Secondary cement injection technique reduces pulmonary embolism in total hip arthroplasty

“…This is underscored by a study where patients with severe systemic diseases and an ASA classification of III or IV were not only affected more severely during surgery, but the effect also lasted over the postoperative period [12]. Similar observations were reported for ventilation and perfusion rates in patients undergoing cemented THA [9,28,29]. Thus, the benefit of the SCT might be even greater for patients with a higher intraoperative complication and morbidity risk as often seen for femoral fractures [17,30].…”

“…Embolism is a feared complication during cemented THA which can lead to cardio-pulmonary distress [9] and even can end fatally. The intraoperative mortality rate for cemented THA has been reported to be approximately 0.1 % [15][16][17].…”

“…Reasons are the good long-term results [1,4,5], the cost effectiveness [6], the high stability in osteoporotic bone and the advantage of full postoperative weight bearing [7,8], which is especially important for elderly people. However, one disadvantage of cemented total hip arthroplasty (THA) is the incidence of embolism with cardiopulmonary distress [9][10][11][12][13][14]. In most patients, it is usually non-fatal, characterised by hypoxia and/or hypotension and occurs around the time of cementation, stem insertion or reduction of the joint [14].…”

Acute Acalculous Cholecystitis following The Cemented Hemiarthroplasty in an Elderly Hip Fracture Patient: Case Report

“…The main explanations include the release of cement methyl methacrylate (MMA) monomers into the circulation, emboli formation during cementing and prosthesis insertion [17], histamine release [18] and complement activation [19]. Firstly, BCIS is mainly concerned with the impact on circulation and the respiratory system [20]. In our department, we have approximately 50 patients undergoing hip arthroplasty for elderly femoral neck fracture patients each year.…”

Intralipid treatment: Is it only the tip of an iceberg? A new suggestion: Bone cement implantation syndrome (BCIS)

“…The haemodynamic perturbations during BCIS have not been extensively studied, particularly not in patients with femoral neck fracture. Kotyra M et al, [17] evaluated the effects of cemented hemiarthroplasty, in these patients, on pulmonary haemodynamics, right ventricular performance, intrapulmonary shunting and physiological dead space.…”