Complications of cemented long-stem hip arthroplasties in metastatic bone disease

R Randall, Stephen K. Aoki, Patrick R. Olson, Steven I. Bott

Research output: Contribution to journalReview article

25 Citations (Scopus)

Abstract

It is controversial whether a cemented long-stem femoral arthroplasty is a safe surgical option for patients with meta-static bone disease of the hip. Cemented long stems increase the risk of embolic cascades and may cause subsequent cardiopulmonary complications, particularly in patients with metastatic disease. We retrospectively reviewed results of 29 long-stem cemented femoral arthroplasties in 27 patients in which surgical techniques that minimized intramedullary debris and canal pressurization were used. The surgical techniques minimized intraoperative cement-related emboli with aggressive medullary lavage, intraoperative canal suctioning during cementation, use of early low-viscosity polymethylmethacrylate, and slow, controlled insertion of the long-stem prosthesis. Cement-associated hypotension occurred in four (14%) patients, sympathomimetics were administered in nine (31%) patients, and a worsening mental status occurred postoperatively in one (3%) patient. There were no cement-associated desaturation events, cardiac arrests, or intraoperative deaths. No patients required prolonged intubation, and there were no postoperative cardiopulmonary events. Cemented long-stem femoral arthroplasty is a safe procedure for patients with high-risk metastatic disease. Increased awareness of cement-related cardiopulmonary pathophysiology, and modifying conventional surgical techniques can minimize cement-associated complications.

Original languageEnglish (US)
Pages (from-to)287-295
Number of pages9
JournalClinical Orthopaedics and Related Research
Issue number443
DOIs
StatePublished - Feb 1 2006
Externally publishedYes

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Bone Diseases
Arthroplasty
Hip
Thigh
Cementation
Sympathomimetics
Therapeutic Irrigation
Polymethyl Methacrylate
Heart Arrest
Embolism
Intubation
Viscosity
Hypotension
Prostheses and Implants

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Complications of cemented long-stem hip arthroplasties in metastatic bone disease. / Randall, R; Aoki, Stephen K.; Olson, Patrick R.; Bott, Steven I.

In: Clinical Orthopaedics and Related Research, No. 443, 01.02.2006, p. 287-295.

Research output: Contribution to journalReview article

Randall, R ; Aoki, Stephen K. ; Olson, Patrick R. ; Bott, Steven I. / Complications of cemented long-stem hip arthroplasties in metastatic bone disease. In: Clinical Orthopaedics and Related Research. 2006 ; No. 443. pp. 287-295.
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