NDLI: Reducing the risk of bone cement implantation syndrome during femoral arthroplasty.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Rothberg, David L. Kubiak, Erik N. Peters, Chris L. Randall, R. Lor Aoki, Stephen K.
Description	Country affiliation: United States Author Affiliation: Rothberg DL ( Department of Orthopaedics, University of Utah, Salt Lake City, UT 84108, USA. .)
Abstract	Patients with pathologic hip fractures or impending pathologic proximal femur fractures are at a high risk for developing bone cement implantation syndrome during cemented femoral arthroplasty. Comorbid conditions of patients who sustain these fractures, including cardiopulmonary compromise and permeable, highly vascular bone related to metastatic disease, put them at risk for sudden death. Reducing intraoperative intramedullary pressure, a modifiable intraoperative intervention, may decrease this risk. The goals of this study were to determine the pressure generated by low- and high-viscosity cement during femoral implantation and the pullout strength of the bone-cement-implant interface.Ten pairs of cadaveric femurs were divided into 2 groups: those receiving low-viscosity cement and those receiving high-viscosity cement during femoral arthroplasty. Pressure was recorded with sensors implanted in the lateral femoral cortex at proximal, middle, and distal implant positions in both groups during cement insertion and prosthesis implantation. Each construct underwent pullout failure testing after thorough cement curing. Significantly higher pressures were generated with high-viscosity cement for implant fixation, whereas the pullout force to failure was similar between groups.Low-viscosity cementation may be used to reduce the risk of bone cement implantation syndrome in high-risk patients with pathologic hip fractures or impending pathologic proximal femur fractures. The proposed mechanism of risk reduction is through lower intramedullary pressure with no bone-cement-implant interface pullout strength reduction. Further clinical trials are needed to prove this biomechanical effect.
Related Links	https://www.healio.com/orthopedics/journals/ortho/2013-4-36-4/{42423fb6-dbd9-4971-b155-4e662a635c54}/reducing-the-risk-of-bone-cement-implantation-syndrome-during-femoral-arthroplasty
File Format	HTM / HTML
ISSN	01477447
e-ISSN	19382367
DOI	10.3928/01477447-20130327-23
Journal	Orthopedics
Issue Number	4
Volume Number	36
Language	English
Publisher	SLACK Incorporated
Publisher Date	2013-04-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Orthopedics Arthroplasty, Replacement, Hip Bone Cements Femur Surgery Hip Fractures Biomechanical Phenomena Pressure
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery

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