Clinical Orthopaedics and Related Research®

, Volume 471, Issue 10, pp 3303–3307

Complications of Cemented Long-stem Hip Arthroplasty in Metastatic Bone Disease Revisited

Authors

  • Shawn L. Price
    • Department of Orthopaedics Sarcoma Services, Huntsman Cancer InstituteUniversity of Utah
  • M. Aabid Farukhi
    • University of Utah School of Medicine
  • Kevin B. Jones
    • Department of Orthopaedics Sarcoma Services, Huntsman Cancer InstituteUniversity of Utah
  • Stephen K. Aoki
    • Department of Orthopaedic SurgeryUniversity of Utah
    • Department of Orthopaedics Sarcoma Services, Huntsman Cancer InstituteUniversity of Utah
Clinical Research

DOI: 10.1007/s11999-013-3113-5

Cite this article as:
Price, S.L., Farukhi, M.A., Jones, K.B. et al. Clin Orthop Relat Res (2013) 471: 3303. doi:10.1007/s11999-013-3113-5

Abstract

Background

The literature suggests that a cemented long-stem femoral arthroplasty is associated with increased intraoperative and perioperative risks. Embolic events may precipitate cardiopulmonary complications and even death; by contrast, others have reported that the use of a cemented long-stem femoral arthroplasty in patients with metastatic bone disease is a safe procedure.

Questions/purposes

Specifically, in this study, we sought to identify (1) intraoperative complications potentially attributable to the use of cemented long-stem femoral components, and (2) early postoperative complications potentially attributable to the use of cemented long-stem femoral components in patients having an arthroplasty for metastatic bone disease.

Methods

In this study, we performed a retrospective chart review of 42 patients (44 arthroplasties), in which the same surgical technique was used. The primary outcome measure was perioperative complications, including intraoperative cement-associated desaturation, cement-associated hypotension, sympathomimetic administration, postoperative hypotension/desaturation, and death.

Results

In this series, 19% of the patients had cement-associated hypotension and sympathomimetics were administered to 48%. Two patients required prolonged intubation. One death occurred during hospitalization but there were no cardiopulmonary events.

Conclusions

This study showed that some patients experienced postoperative desaturation, prolonged intubation, and increased use of sympathomimetics, however, these events were short-lived and did not result in patient mortality. Although there are significant risks to cemented long-stem femoral arthroplasty, it can be performed with a low risk of fatal cardiopulmonary complications and remains a surgical option when treating patients with metastatic bone disease.

Level of Evidence

Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons® 2013