title: Fat embolism syndrome after cementless total hip arthroplasty.
abstract: There are few reports in the literature of fat embolism syndrome after cementless total hip arthroplasty (THA). Most reported cases have occurred after fracture or cemented THA. We report a case of a healthy 51-year-old woman who underwent THA for osteoarthritis under spinal anesthesia. A press-fit cup and extensively porous-coated diaphyseal locking stem were used and inserted without cement. In the recovery room, the patient became hypoxemic and hypotensive and developed cortical blindness. The next day, a petechial rash was evident. Gurd's criteria for fat embolism syndrome were fulfilled. Her symptoms resolved over a 2-week period. Patients undergoing cementless THA are at risk for fat embolism syndrome, and this must be considered in the differential diagnosis for postoperative hypoxemia and neurologic deficits.
authors.affiliation: London Health Sciences Centre, Ontario, Canada.
authors.forename: J J
authors.initials: JJ
authors.lastname: Gelinas
authors.forename: R
authors.initials: R
authors.lastname: Cherry
authors.forename: S J
authors.initials: SJ
authors.lastname: MacDonald
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D004620:Embolism, Fat / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D011183:Postoperative Complications; D013577:Syndrome