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Complications of cemented long-stem hip arthroplasty in metastatic bone disease revisited.

Abstract：

BACKGROUND:The literature suggests that a cemented long-stem femoral arthroplasty is associated with increased intraoperative and perioperative risks. Embolic events may precipitate cardiopulmonary complications and even death; by contrast, others have reported that the use of a cemented long-stem femoral arthroplasty in patients with metastatic bone disease is a safe procedure. QUESTIONS/PURPOSES:Specifically, in this study, we sought to identify (1) intraoperative complications potentially attributable to the use of cemented long-stem femoral components, and (2) early postoperative complications potentially attributable to the use of cemented long-stem femoral components in patients having an arthroplasty for metastatic bone disease. METHODS:In this study, we performed a retrospective chart review of 42 patients (44 arthroplasties), in which the same surgical technique was used. The primary outcome measure was perioperative complications, including intraoperative cement-associated desaturation, cement-associated hypotension, sympathomimetic administration, postoperative hypotension/desaturation, and death. RESULTS:In this series, 19% of the patients had cement-associated hypotension and sympathomimetics were administered to 48%. Two patients required prolonged intubation. One death occurred during hospitalization but there were no cardiopulmonary events. CONCLUSIONS:This study showed that some patients experienced postoperative desaturation, prolonged intubation, and increased use of sympathomimetics, however, these events were short-lived and did not result in patient mortality. Although there are significant risks to cemented long-stem femoral arthroplasty, it can be performed with a low risk of fatal cardiopulmonary complications and remains a surgical option when treating patients with metastatic bone disease. LEVEL OF EVIDENCE:Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

journal_name

Clin Orthop Relat Res

journal_title

Clinical orthopaedics and related research

authors

Price SL,Farukhi MA,Jones KB,Aoki SK,Randall RL

doi

10.1007/s11999-013-3113-5

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

3303-7

issue

eissn

0009-921X

issn

1528-1132

journal_volume

471

pub_type

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Complications of cemented long-stem hip arthroplasty in metastatic bone disease revisited.