Measures for Reducing the Risk of the Bone Cement Implantation Syndrome (BCIS) During Total Hip Replacement

 

Measures to reduce the risk of BCIS during joint arthroplasty:

(1) Prior to surgery identify a patient at increased risk for BCIS by identifying risk factors for its occurrence. Adjust the procedure accordingly.

(2) Maintain normovolemia during surgery, especially during cement insertion.

(3) Maintain vigilance during instrumentation and fixation of the implant.

(4) Alert the anesthesiologist and other team members prior to inserting cement.

(5) Thoroughly lavage the femoral canal before broaching the canal and further instrumentation of the femur.

(6) Consider use of a suction catheter to reduce the pressure within the intramedullary canal.

(7) Introduce cement into the femur with a cement gun in a retrograde fashion.