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British Journal of Anaesthesia 2009 102(1):12-22; doi:10.1093/bja/aen328
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2009. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Bone cement implantation syndrome

A. J. Donaldson1, H. E. Thomson1, N. J. Harper2,* and N. W. Kenny3

1 Department of Anaesthesia, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK
2 Department of Anaesthesia
3 Department of Orthopaedic Surgery, Manchester Royal Infirmary, Oxford Rd, Manchester M13 9WL, UK

* Corresponding author. E-mail: nigel.harper{at}manchester.ac.uk

Bone cement implantation syndrome (BCIS) is poorly understood. It is an important cause of intraoperative mortality and morbidity in patients undergoing cemented hip arthroplasty and may also be seen in the postoperative period in a milder form causing hypoxia and confusion. Hip arthroplasty is becoming more common in an ageing population. The older patient may have co-existing pathologies which can increase the likelihood of developing BCIS. This article reviews the definition, incidence, clinical features, risk factors, aetiology, pathophysiology, risk reduction, and management of BCIS. It is possible to identify high risk groups of patients in which avoidable morbidity and mortality may be minimized by surgical selection for uncemented arthroplasty. Invasive anaesthetic monitoring should be considered during cemented arthroplasty in high risk patients.

Keywords: complications, death; complications, embolism; complications, hypotension; complications, hypoxia; surgery, orthopaedic


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This article has been cited by other articles:


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 Br J AnaesthHome page
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Bone cement implantation syndrome
Baha Al-Shaikh
British Journal of Anaesthesia, 3 Jan 2009 [Full text]
PREVENTIVE CLOSURE OF A PATENT FORAMEN OVALE PRIOR TO TOTAL HIP REPLACEMENT
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Re: PREVENTIVE CLOSURE OF A PATENT FORAMEN OVALE PRIOR TO TOTAL HIP REPLACEMENT
Nigel J Harper, et al.
British Journal of Anaesthesia, 14 Apr 2009 [Full text]

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