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Bone cement implantation syndrome: a scoping review
Karen E Brokke1, Manon Graman2, Sjoerd Servaas3
1Department of Orthopaedic Surgery, Spaarne Gasthuis Academy, Hoofddorp, The Netherlands; Department of Anaesthesiology, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
British Journal of Anaesthesia
|July 9, 2025
Summary
Bone cement implantation syndrome (BCIS) can occur in any arthroplasty, with varying incidence rates. Understanding BCIS risk factors like age and patient status is crucial for managing this complication.
Area of Science:
- Orthopedic Surgery
- Anesthesiology
- Critical Care Medicine
Background:
- Bone cement implantation syndrome (BCIS) is a serious complication during arthroplasty, characterized by hemodynamic and respiratory changes.
- The increasing volume of arthroplasty procedures necessitates a thorough understanding of BCIS incidence and risk factors.
Purpose of the Study:
- To provide a comprehensive scoping review of current knowledge on bone cement implantation syndrome.
- To elucidate the incidence, risk factors, and characteristics of BCIS across different arthroplasty types.
Main Methods:
- A systematic scoping review adhering to the PRISMA-ScR Checklist.
- Literature search conducted across major databases: PubMed, Cochrane, and Embase.
- Inclusion of 85 relevant studies for analysis.
Main Results:
- BCIS incidence varied significantly: 15.4%-46.7% (cemented hip), 27.5%-70.7% (cemented knee), 16.2% (shoulder), and 0.0%-21.8% (uncemented hip).
- Identified risk factors include advanced age, ASA physical status 3 or 4, and history of lung cancer or metastasis.
Conclusions:
- BCIS is a potential complication in both cemented and uncemented arthroplasty, not solely dependent on cement use.
- The severity of BCIS may be associated with the chosen fixation method.
