Bilateral Femoral Nutrient Foraminal Cement Penetration during Total Hip Arthroplasty.
BACKGROUND
Cement pressurisation is important for the insertion of both the acetabular and femoral components during Total Hip Arthroplasty (THA). Secondary to pressurization the rare phenomenon of unilateral cement incursion into the nutrient foramen has previously been reported. No bilateral case has been reported to date. This has implications both for misdiagnosis of periprosthetic fractures and for medico-legal consequences due to a presumed adverse intra-operative event.


METHODS
We present a case report of a 59 year old, caucasian female who underwent staged bilateral cemented Stanmore THA. The post-operative radiographs demonstrate evidence of bilateral nutrient foramen penetration intra-operatively by standard viscosity cement. The patient suffered no adverse consequences.


CONCLUSIONS
In summary, cement extravasation into the nutrient foramen is an important differential to be considered in presence of posterior-medial cement in the diaphysis of femur following THA. This requires no further intervention and has no effect on the outcome.
Department of Orthopaedic Surgery. Luton and Dunstable Hospital, Lewsey Road, Luton, UK.
Ross
R
Coomber
London Sarcoma Service. Royal National Orthopaedic Hospital. Stanmore. London.
Rej S
RS
Bhumbra
Dept of Orthopaedics and Trauma. Bonney House. St. Mary's Hospital. Imperial College of Medicine, Norfolk Place. Paddington. London. UK.
Robert
R
Marston
Cement; Nutrient Foramen; Polymethyl methacrylate; Total Hip Arthroplasty