Embolic events during total hip arthroplasty: an echocardiographic study.
We performed transesophageal echocardiography on 88 patients treated with cementless or hybrid total hip arthroplasty (THA). We observed a significantly higher frequency of severe embolic events among patients without cup holes during insertion of press-fit cups (46.0%) than in patients with holes (15.6%) (P<.005). During stem insertion, severe embolic events occurred in 61.5% of hybrid operations and 5.9% of cementless operations. PaO(2), systolic blood pressure, and arterial oxygen saturation decreased significantly in severe embolic events (P<.05). The results indicate that embolic events may occur during THA whether or not cement is used. Based on these findings, we make several recommendations for technique modifications during insertion of both femoral and acetabular components in THA.
Hagio
Keisuke
K
Department of Orthopaedic Surgery, Osaka University Medical School, Osaka, Japan.
Sugano
Nobuhiko
N
Takashina
Masaki
M
Nishii
Takashi
T
Yoshikawa
Hideki
H
Ochi
Takahiro
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006621:Hip Joint; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications; D007592:Joint Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012307:Risk Factors