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Catastrophic cement reaction following cementation for megaprosthesis for proximal femoral fracture
  1. Muhammad Nouman Baig1,
  2. William Curtin1,
  3. Michael Andrew Callaghan2,
  4. Colin G Murphy1
  1. 1Department of Trauma and Orthopaedics, Galway University Hospital, Galway, Ireland
  2. 2Department of Anaesthesia, Galway University Hospital, Galway, Ireland
  1. Correspondence to Dr Muhammad Nouman Baig, nouman142{at}


Bone cement implantation syndrome (BCIS) is a well-described and potentially fatal complication of orthopaedic surgery involving pressurised bone cement. Although also described for certain spinal procedures, it is most commonly associated with cemented hip and knee arthroplasty and with cemented hemiarthroplasty following neck of femur fracture in particular.

Donaldson et alproposed the definition of BCIS as a syndrome “characterized by hypoxia, hypotension or both and/or unexpected loss of consciousness occurring around the time of cementation, prosthesis insertion, reduction of the joint or, occasionally, limb tourniquet deflation in a patient undergoing cemented bone surgery”. Other features include increased vascular resistance, cardiac arrhythmias and cardiac arrest post cement use.

We describe a case of a patient who suffered a catastrophic reaction to cement during surgery for a comminuted proximal femoral fracture.

  • drug interactions
  • orthopaedic and trauma surgery

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  • Contributors All authors contributed to the manuscript as follows: MNB and CGM: conception, design, analysis and interpretation of data. MNB, CGM, WC and MAC: drafting the article. MNB, CGM, WC and MAC: revising it critically for important intellectual content. MNB, CGM, WC and MAC: final approval of the version to be published. All authors read and approved the final manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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