Hemodynamic changes in patients undergoing cemented total hip replacement surgery: a literature review

Putu Astawa

doi:10.15562/bmj.v9i2.1691

Hemodynamic changes in patients undergoing cemented total hip replacement surgery: a literature review

Putu Astawa ,

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DOI: https://doi.org/10.15562/bmj.v9i2.1691 |
Published: 2020-08-01

Abstract

Cemented total hip arthroplasty is believed to offer adequate pain relief, satisfactory walking ability, and activities of daily living as one of the most widely used techniques for treating hip fragility fractures. However, some complications may occur perioperatively, not to mention the catastrophic bone cement implantation syndrome. Thorough assessment, perioperative monitoring, early detection, and treatment plays an essential role to maximalize the result of this procedure, as well as minimalizing morbidity and mortality. Some anesthetic measures that can be done in order to keep the stability of intraoperative conditions are avoiding volatile anesthetic agents in high-risk patients, administering 100% inspired oxygen throughout the procedure, invasive hemodynamic monitoring, and maintenance of normovolemia.

A central line placement also provides a rapid route of drug administration if resuscitation becomes necessary. Orthopaedic surgeons should also consider thorough lavage of the femoral medullary canal, especially pulsatile jet lavage, removal of tissues before cementation to minimize the formation of microemboli during the procedure, and using cement restrictor to compartmentalize the bone marrow tissue and blood separately from the cement. Therefore, it can be concluded that understanding hemodynamic changes during this procedure is essential, not only for the operator but also for the anaesthesiologists.

References

Miyamoto S, Nakamura J, Iida S, Shigemura T, Kishida S, Abe I, et al. Intraoperative blood pressure changes during cemented versus uncemented bipolar hemiarthroplasty for displaced femoral neck fracture: a multi-center cohort study: The effect of bone cement for bipolar hemiarthroplasty in elderly patients. Arch Orthop Trauma Surg. 2017;137(4):523-529.
Chammout G, Muren O, Laurencikas E, Boden J, Kelly-Pattersson P, Sjoo H, et al. More complications with uncemented than cemented femoral stems in total hip replacement for displaced femoral neck fractures in the elderly: A single-blinded, randomized controlled trial with 69 patients. Acta Orthop. 2017;88(2):145-151.
Donaldson AJ, Thomson HE, Harper NJ, Kenny NW. Bone cement implantation syndrome. Br J Anaesth. 2009;102(1):12-22.
Nolan J. Arterial oxygenation and mean arterial blood pressure in patients undergoing total hip replacement: cemented versus uncemented components. Anaesthesia. 1994;49(4):293-299.
Soleimanha M, Sedighinejad A, Haghighi M, Nabi BN, Mirbolook AR, Mardani-Kivi M. Hemodynamic and arterial blood gas parameters during cemented hip hemiarthroplasty in elderly patients. Arch Bone Jt Surg. 2014;2(3):163-167.
Khanna G, Cernovsky J. Bone cement and the implications for anaesthesia. Contin Educ Anaesthesia, Crit Care Pain. 2012;12(4):213-216.
Segerstad MH af, Olsen F, Patel A, Houltz E, NellgÃ¥rd B, Ricksten SE. Pulmonary haemodynamics and right ventricular function in cemented vs uncemented total hip arthroplastyâ€”A randomized trial. Acta Anaesthesiol Scand. 2019;63(3):298-305.
Fujita H, Okumura T, Hara H, Toda H, Harada H, Nishimura R, et al. Monitoring of blood pressure during total hip arthroplasty using the interface bioactive bone cement (IBBC) technique. J Orthop Sci. 2015;20(2):347-56.
Memtsoudis SG, Salvati EA, Go G, Ma Y, Sharrock NE. Perioperative pulmonary circulatory changes during bilateral total hip arthroplasty under regional anesthesia. Reg Anesth Pain Med. 2010;35(5):417-421.
Kalra A, Sharma A, Palaniswamy C, El-Oshar S, Desai P, Yazbeck M, et al. Diagnosis and management of bone cement implantation syndrome: Case report and brief review. Am J Ther. 2013;20(1):121-125.

[1] Miyamoto S, Nakamura J, Iida S, Shigemura T, Kishida S, Abe I, et al. Intraoperative blood pressure changes during cemented versus uncemented bipolar hemiarthroplasty for displaced femoral neck fracture: a multi-center cohort study: The effect of bone cement for bipolar hemiarthroplasty in elderly patients. Arch Orthop Trauma Surg. 2017;137(4):523-529.

[2] Chammout G, Muren O, Laurencikas E, Boden J, Kelly-Pattersson P, Sjoo H, et al. More complications with uncemented than cemented femoral stems in total hip replacement for displaced femoral neck fractures in the elderly: A single-blinded, randomized controlled trial with 69 patients. Acta Orthop. 2017;88(2):145-151.

[3] Donaldson AJ, Thomson HE, Harper NJ, Kenny NW. Bone cement implantation syndrome. Br J Anaesth. 2009;102(1):12-22.

[4] Nolan J. Arterial oxygenation and mean arterial blood pressure in patients undergoing total hip replacement: cemented versus uncemented components. Anaesthesia. 1994;49(4):293-299.

[5] Soleimanha M, Sedighinejad A, Haghighi M, Nabi BN, Mirbolook AR, Mardani-Kivi M. Hemodynamic and arterial blood gas parameters during cemented hip hemiarthroplasty in elderly patients. Arch Bone Jt Surg. 2014;2(3):163-167.

[6] Khanna G, Cernovsky J. Bone cement and the implications for anaesthesia. Contin Educ Anaesthesia, Crit Care Pain. 2012;12(4):213-216.

[7] Segerstad MH af, Olsen F, Patel A, Houltz E, NellgÃ¥rd B, Ricksten SE. Pulmonary haemodynamics and right ventricular function in cemented vs uncemented total hip arthroplastyâ€”A randomized trial. Acta Anaesthesiol Scand. 2019;63(3):298-305.

[8] Fujita H, Okumura T, Hara H, Toda H, Harada H, Nishimura R, et al. Monitoring of blood pressure during total hip arthroplasty using the interface bioactive bone cement (IBBC) technique. J Orthop Sci. 2015;20(2):347-56.

[9] Memtsoudis SG, Salvati EA, Go G, Ma Y, Sharrock NE. Perioperative pulmonary circulatory changes during bilateral total hip arthroplasty under regional anesthesia. Reg Anesth Pain Med. 2010;35(5):417-421.

[10] Kalra A, Sharma A, Palaniswamy C, El-Oshar S, Desai P, Yazbeck M, et al. Diagnosis and management of bone cement implantation syndrome: Case report and brief review. Am J Ther. 2013;20(1):121-125.

Hemodynamic changes in patients undergoing cemented total hip replacement surgery: a literature review

Abstract

References

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