Occurrence, risk factors, and outcomes of bone cement implantation syndrome after hemi and total hip arthroplasty in cancer patients Journal Article


Authors: Schwarzkopf, E.; Sachdev, R.; Flynn, J.; Boddapati, V.; Padilla, R. E.; Prince, D. E.
Article Title: Occurrence, risk factors, and outcomes of bone cement implantation syndrome after hemi and total hip arthroplasty in cancer patients
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. © 2019 Wiley Periodicals, Inc.
Keywords: adolescent; adult; aged; aged, 80 and over; middle aged; leukemia; survival rate; retrospective studies; young adult; major clinical study; overall survival; mortality; bone metastasis; pathophysiology; cancer patient; pancreas cancer; postoperative care; follow up; follow-up studies; endometrium cancer; preoperative evaluation; neoplasm; neoplasms; colorectal cancer; melanoma; multiple myeloma; ovary cancer; breast cancer; incidence; risk factors; lung cancer; deep vein thrombosis; retrospective study; bladder cancer; risk factor; pneumonia; prostate cancer; sarcoma; hypoxia; lung embolism; postoperative complication; postoperative complications; hypotension; lung metastasis; hospitalization; syndrome; shock; operation duration; lymphoma; comorbidity; blood pressure; thyroid cancer; perioperative period; embolism; kidney cancer; uterus cancer; wound dehiscence; oxygen saturation; oxygenation; functional status; respiratory failure; recovery room; orthopedic surgery; bone cement; clinical outcome; bone cements; cancer patients; reconstructive surgery; arthroplasty, replacement, hip; hip replacement; hip hemiarthroplasty; femoral neck fractures; very elderly; operative blood loss; humans; prognosis; human; male; female; priority journal; article; femoral neck fracture; bone cement implantation syndrome; total hip replacement
Journal Title: Journal of Surgical Oncology
Volume: 120
Issue: 6
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2019-11-01
Start Page: 1008
End Page: 1015
Language: English
DOI: 10.1002/jso.25675
PUBMED: 31432531
PROVIDER: scopus
PMCID: PMC7357733
DOI/URL:
Notes: Source: Scopus
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MSK Authors
  1. Roger E Padilla
    11 Padilla
  2. Daniel Eduardo Prince
    8 Prince
  3. Jessica Flynn
    77 Flynn