Bone Cement Emboli after Arthroplasty: Is It Possible? A Case Report and Literature Review

Seyyed-Morteza Kazemi; Sohrab Keyhani; Mohammadreza  Miniator Sajjadi; Ramin Etemadi; Seyyed-Mohsen Hosseininejad; Hoda Nouri

doi:10.18502/jost.v9i2.12629

Seyyed-Morteza Kazemi Professor, Department of Orthopedic Surgery, Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Sohrab Keyhani Professor, Department of Orthopedic Surgery, Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mohammadreza Miniator Sajjadi Associate Professor, Department of Orthopedic Surgery, Teleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Ramin Etemadi Assistant Professor, Department of Orthopedic Surgery, 5th Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran
Seyyed-Mohsen Hosseininejad Orthopedic Surgeon, Bone Joint and Related Tissues Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Joint, Bone, Connective tissue Rheumatology Research Center (JBCRC), Golestan University of Medical Sciences, Gorgan, Iran
Hoda Nouri Cardiologist, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jost.v9i2.12629

Keywords: Bone Cement; Polymethylmethacrylate; Pulmonary Embolism; Knee Replacement Arthroplasty; Vertebroplasty

Abstract

Background: Polymethylmethacrylate (PMMA) has been extensively used as bone cement in orthopedic procedures. Pulmonary cement embolisms (PCEs) are supposed to originate from cement extravasation into the basivertebral veins before draining into the inferior vena cava and eventually becoming lodged in the pulmonary capillaries. Few cases of bone cement embolism have been reported. This study reported a case of pulmonary embolism (PE) after thoracolumbar fixation and kyphoplasty and reviewed the current literature.

Case Report: We presented an 81-year-old woman who had undergone thoracolumbar vertebroplasty three months before admission and became symptomatic due to PE after total knee arthroplasty (TKA).

Conclusion: This case illustrates that clinicians must be aware of the probable occurrence of respiratory distress syndrome in patients with a history of vertebroplasty.