This retrospective study examined grade 3 bone cement implantation syndrome across hip and knee arthroplasty procedures at four Dutch hospitals. Cases required cardiovascular collapse needing CPR between joint manipulation and skin closure. There were no cases among 25,914 knee arthroplasties, versus 31 among 39,237 hip procedures (0.08%). Of these 31 cases, 27 occurred during hemiarthroplasty for femoral neck fracture. Affected patients had a mean age of 86.2 years, 87.1% underwent cemented procedures, and perioperative mortality was 67.7%, highlighting the severe outcomes accompanying this uncommon perioperative arrest syndrome.
This series identifies a rare perioperative arrest syndrome with high mortality, concentrated in elderly patients undergoing hip-fracture hemiarthroplasty. It does not establish preventive or resuscitation strategies.
Study limitation: Retrospective case ascertainment and only 31 events limit precision; the abstract does not define the perioperative mortality time window.
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