Eugenia Schwarzkopf1, Ridhi Sachdev2, Jessica Flynn3, Venkat Boddapati4, Roger E Padilla5, Daniel E Prince6. 1. Sloan Kettering Institute, New York, New York. 2. Montefiore Orthopedic Surgery, New York, New York. 3. Department of Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York. 4. New York-Presbyterian/Columbia University Medical Center, New York, New York. 5. Department of Anesthesiology & Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. 6. Orthopaedic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Abstract
BACKGROUND AND OBJECTIVES: Patients undergoing cement fixation for hip arthroplasty are at increased risk of developing bone cement implantation syndrome (BCIS). We sought to determine: what is the occurrence of BCIS in patients with cancer after hip arthroplasty? What are the risk factors in patients with cancer for the development of this syndrome? What is the outcome for patients with cancer having BCIS? METHODS: We identified 374 patients with cancer who underwent cemented hip arthroplasty between 2010 and 2014. Patient characteristics, operative variables, and outcomes were collected. RESULTS: BCIS occurred in 279 (75%) patients. A total of 353 (94%) patients had bone metastases and 179 (48%) patients had lung metastases at the time of surgery. Age greater than 60 (hazard ratio [HR] 2.09, P = .02) and the presence of lung metastases (HR 1.77, P = .019) were associated with increased risk of BCIS. Increased perioperative use of vasopressors (HR 1.72, P = .023) and increased hospital stay beyond 10 days (HR 2.67, P = .003) was associated with BCIS. CONCLUSIONS: BCIS is a frequent clinical event in patients with cancer undergoing femoral cemented arthroplasty with increased risk for patients over age 60 and those with compromised lung function due to lung metastases and lung cancer. Patients who develop BCIS are more likely to require longer postoperative hospitalization. Careful preoperative assessment and intraoperative communication are crucial steps to reduce the consequences of BCIS.
BACKGROUND AND OBJECTIVES:Patients undergoing cement fixation for hip arthroplasty are at increased risk of developing bone cement implantation syndrome (BCIS). We sought to determine: what is the occurrence of BCIS in patients with cancer after hip arthroplasty? What are the risk factors in patients with cancer for the development of this syndrome? What is the outcome for patients with cancer having BCIS? METHODS: We identified 374 patients with cancer who underwent cemented hip arthroplasty between 2010 and 2014. Patient characteristics, operative variables, and outcomes were collected. RESULTS:BCIS occurred in 279 (75%) patients. A total of 353 (94%) patients had bone metastases and 179 (48%) patients had lung metastases at the time of surgery. Age greater than 60 (hazard ratio [HR] 2.09, P = .02) and the presence of lung metastases (HR 1.77, P = .019) were associated with increased risk of BCIS. Increased perioperative use of vasopressors (HR 1.72, P = .023) and increased hospital stay beyond 10 days (HR 2.67, P = .003) was associated with BCIS. CONCLUSIONS:BCIS is a frequent clinical event in patients with cancer undergoing femoral cemented arthroplasty with increased risk for patients over age 60 and those with compromised lung function due to lung metastases and lung cancer. Patients who develop BCIS are more likely to require longer postoperative hospitalization. Careful preoperative assessment and intraoperative communication are crucial steps to reduce the consequences of BCIS.
Authors: Rachid Rassir; Maarten Schuiling; Inger N Sierevelt; Casper W P van der Hoeven; Peter A Nolte Journal: Clin Orthop Relat Res Date: 2021-04-01 Impact factor: 4.176
Authors: Christopher G Larsen; William K Crockatt; Michael Fitzgerald; Nanette Matos; Howard J Goodman; Samuel Kenan; Shachar Kenan Journal: J Orthop Date: 2020-05-04