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Intraoperative cerebral arterial embolization during total hip arthroplasty
C R Edmonds1, D Barbut, D Hager
1Department of Anesthesiology, The Hospital for Special Surgery, New York, NY 10021, USA. EdmondsC@hss.edu
Anesthesiology
|July 26, 2000
Summary
Cerebral microemboli can occur during total hip arthroplasty, particularly when inserting cemented components. Further research is needed to understand the impact of these emboli on cognitive function post-surgery.
Area of Science:
- Orthopedic Surgery
- Neurology
- Cardiovascular Science
Background:
- Fat embolism is a known complication of total hip arthroplasty (THA), especially with cemented femoral components.
- Fat and air bubbles can enter systemic circulation through a patent foramen ovale or pulmonary circulation.
Purpose of the Study:
- To investigate the occurrence of cerebral microemboli during THA.
- To assess the relationship between surgical events and embolic signals in the brain.
Main Methods:
- Transcranial Doppler (TCD) assessment of the middle cerebral artery in 23 patients undergoing THA.
- Surgery performed in the lateral decubitus position with TCD probe on the nondependent side.
Main Results:
- Embolic signals were detected in 8 out of 20 patients during THA.
- Signals occurred during cemented component impaction or hip relocation.
- Some patients experienced mild respiratory symptoms or agitation associated with embolic signals.
Conclusions:
- Cerebral microemboli are a potential complication during total hip arthroplasty.
- The contribution of these microemboli to postoperative cognitive dysfunction remains undetermined.