Pulmonary cement embolism is frequently observed but not a contributing factor for death in patients with cemented total hip and knee arthroplasty: a postmortem study.
Int Orthop
; 46(6): 1225-1232, 2022 06.
Article
em En
| MEDLINE
| ID: mdl-35352160
ABSTRACT
PURPOSE:
Bone cement is frequently used for implant fixation in orthopaedic surgery. The occurrence of pulmonary cement embolism (PCE) in hip and knee arthroplasty has been described previously, but the exact extent and frequency have not been adequately studied. A postmortem cohort provides a unique opportunity for a more detailed analysis of this phenomenon.METHODS:
Through retrospective analysis of whole-body computed tomography (CT) scans and autopsy protocols, we identified 67 cases with previous cemented total hip or knee arthroplasties. A grading system originally developed for PCE after cemented spine procedures was used. Findings were compared with two control groups 35 individuals with previous cementless total joint arthroplasty as well as 25 individuals without evidence of prostheses.RESULTS:
PCE was detected in 46.3% of the cases grade 1 (31.3%), grade 2 (10.5%), and grade 3 (4.5%). No statistically significant difference was found between hip and knee arthroplasties in terms of PCE frequency. Importantly, none of the autopsy reports listed PCE as a cause of death or a contributing factor for the patients' death. In the two control groups, only one case per group was classified as grade 1 PCE, while the remaining cases did not show any evidence of PCE.CONCLUSION:
The presented data reveal a high frequency of PCE in hip and knee arthroplasties, which is almost identical to previous findings in patients with cement-augmented interventions in the spine. This way, our results underline the relevance of PCE after arthroplasty, suggesting an adaptation of surgical methods to minimize this complication.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Embolia Pulmonar
/
Artroplastia de Quadril
/
Artroplastia do Joelho
Tipo de estudo:
Etiology_studies
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Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article