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Cardiac arrest during hip arthroplasty with a cemented long-stem component. A report of seven cases
B M Patterson1, J H Healey, C N Cornell
1Hospital for Special Surgery, New York, N.Y. 10021.
Insights
Cardiac arrest during hip arthroplasty using cemented long-stem femoral components poses significant risks, especially for elderly patients with osteoporotic bone. Careful cement pressurization and hemodynamic monitoring are crucial to mitigate these risks.
Area of Science:
- Orthopedic Surgery
- Cardiology
- Biomaterials Science
Background:
- Hip arthroplasty is a common procedure to address hip joint issues.
- Cemented femoral components are widely used, but potential complications exist.
- Cardiac arrest during surgery is a rare but severe adverse event.
Abstract:
Seven patients had a cardiac arrest during hip arthroplasty with a cemented long-stem femoral component. Four patients died in the operating room, and three patients were successfully resuscitated. When the three survivors were eventually discharged from the hospital, they had no known permanent cardiac, pulmonary, or neurological sequelae. Factors that were common to all of the patients were advanced age, osteoporotic bone, a previously undisturbed intramedullary canal, and use of a long-stem femoral component and several batches of methylmethacrylate. Hip arthroplasty with a long-stem femoral component is associated with substantial risk in these patients. Excessive pressurization of cement should be avoided, and invasive hemodynamic monitoring should be used when the described conditions are present.