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New clinico-pathophysiological studies on the bone cement implantation syndrome

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Summary

Implantation of endoprostheses with bone cement is followed by alterations of the circulation. Intoxication, caused by the monomer of bone cement or pulmonary embolism by intramedullary contents constitute the two mostly accepted pathophysiological hypotheses. Because of the lack of pulmonal and circulatory physiological data a clinical decision concerning the value of the hypotheses was not possible until now. Hip prosthesis implantation was analyzed in 15 patients by measuring equipment controlled by an on-line-computer. The device allowed a high rate of data retrieval. The bone cement implantation syndrome reveals itself as cardiorespiratory sequelae of a disseminated pulmonary embolism which is originating in intramedullary contents, sqeezed intravasal. Usual prophylactic methods are revisited.

Zusammenfassung

Bei der Endoprothesenimplantation mittels Knochenzement treten Kreislaufreaktionen auf. Zwischen den verbreiteten pathologischen Hypothesen hierfür — Knochenzement-Monomer-Intoxikation und Markinhaltlungenembolie — konnte bisher klinisch mangels lungen- und kreislaufphysiologischer Daten nicht entschieden werden. Mit Hilfe einer prozeßrechnergesteuerten Meßanlage wird die Hüftgelenkimplantation bei 15 Patienten mit hoher Registrierfrequenz zahlreicher Parameter untersucht. Das Knochenzement-Implantations-Syndrom stellt sich als cardiorespiratorische Folge einer disseminierten pulmonalen Embolie dar, die durch die intravasale Einpressung von Markrauminhalt ausgelöst wird. Die üblichen Prophylaxemaßnahmen werden unter diesen Gesichtspunkten revidiert.

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  1. Chirurgische Klinik Dr. Rinecker, Isartalstraße 82, D-8000, München 70, Germany

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Rinecker, H. New clinico-pathophysiological studies on the bone cement implantation syndrome. Arch Orthop Traumat Surg 97, 263–274 (1980). https://doi.org/10.1007/BF00380707

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