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[Thromboembolic complications related to the use of bone cement in hip arthroplasty--pathogenesis and prophylaxis]

C Heisel1, M Clarius, U Schneider

  • 1Abteilung Orthopädie I, Orthopädische Universitätsklinik Heidelberg.

Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete
|August 7, 2001
PubMed

Insights

Thromboembolic complications during total hip arthroplasty (THA) can be minimized by optimizing canal preparation and lavage techniques. While cementless implants may reduce embolic load, the overall risk of serious complications remains low.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Cardiovascular Complications

Context:

  • Total hip arthroplasty (THA) using bone cement is associated with cardiovascular risks.
  • Intravasation of fat and bone marrow into circulation can occur during cemented THA.
  • Thromboembolic complications are a significant concern in cemented THA procedures.

Purpose:

  • To review the literature on thromboembolic complications linked to bone cement in THA.
  • To identify methods for reducing embolic load during THA.
  • To evaluate the impact of cementing techniques on implant stability and complication rates.

Summary:

  • Optimizing canal preparation and lavage, particularly with jet lavage, is crucial for reducing embolic load and enhancing bone-cement interface strength.
  • Modern cementing techniques, including pulsatile lavage, cement restrictors, and pressurization, alongside adequate medullary canal drainage, minimize thromboembolic risks.
  • While cementless THA may present a lower intravasation risk, thromboembolic complications can still occur; however, this risk alone should not dictate implant choice due to the low overall incidence of severe outcomes.

Impact:

  • Highlights the importance of surgical technique in mitigating risks associated with cemented THA.
  • Provides insights into optimizing cementing procedures to improve patient safety.
  • Informs clinical decision-making regarding implant selection by contextualizing thromboembolic risk within the broader complication profile.
Abstract

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