All of the incidents occurred between 2005 and 2012 at hospitals in England and Wales. Patients were undergoing a hemiarthroplasty, which is an operation that is commonly used to treat hip fractures. It is similar to a hip replacement, but replaces only the “ball” part of the hip joint, not the socket.
In 2009, the National Patient Safety Agency (NPSA) warned about a cluster of cases in which patients suddenly died during a hip hemiarthroplasty. The warning did not receive much attention, which is surprising because 22,000 people in the U.K. undergo this procedure every year.
The deaths were linked to bone cement, an optional tool in hip hemoarthroplasty. One disadvantage of bone cement is a risk of bone cement implantation syndrome (BCIS). This condition occurs when fat and marrow contents travel in the bloodstream. It can potentially cause a pulmonary embolism, very low blood pressure, hypoxia (low oxygen), cardiac arrest, and death.
Researchers evaluated data from the National Reporting and Learning System (NRLS), a database of adverse events. After evaluating incidents involving bone cement, they found 62 reports involving severe injury or death between 2005 and 2012. Patients died in two-thirds of cases. In 14 cases, patients had a cardiac arrest but were successfully resuscitated. In about 75% of cases, deterioration occurred within 3 minutes of bone cement being inserted. Researchers estimated that 1 in 3,000 patients suffered cardiac arrest or death.
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