All that clots is not blood: Bone cement implantation syndrome presenting as an intracardiac mass and pulmonary embolism

Bone cement implantation syndrome (BCIS) is a rare and potentially fatal perioperative complication of cemented orthopaedics surgery. A CT-pulmonary angiogram and echocardiogram images were acquired from an 88-year-old patient who had a perioperative collapse while undergoing a revision operation for a peri-implant fracture of the right femoral neck. Findings were suggestive of an intracardiac clot connected to a saddle pulmonary artery embolus. Patient also developed disseminated intravascular coagulation. Overall findings were suggestive of bone cement implantation syndrome.

Orthopaedic surgery

This chapter discusses the anaesthetic management of orthopaedic surgery. It begins with general principles of the anaesthetic management of orthopaedic surgical patients, including the management of fat embolism syndrome (FES), bone cement implantation syndrome (BCIS), and the use of tourniquets. Surgical procedures covered include total hip joint replacement (THJR) (including revision THJR); femoral neck fracture surgery; total knee joint replacement (TKJR); arthroscopy; cruciate ligament repair; ankle surgery; foot surgery; spinal surgery (including the cervical spine); shoulder surgery (including total shoulder joint replacement (TSJR)); elbow replacement surgery and hand surgery.

Delayed presentation of bone cement implantation syndrome requiring extracorporeal membrane oxygenation support

Bone cement implantation syndrome is a rare and potentially fatal complication which may occur following cemented bone surgery. Herein, we present a case of delayed and fatal presentation of bone cement implantation syndrome following cemented spinal surgery, despite mechanical support with extracorporeal mechanical oxygenation.