The Bone Cement Hypercoagulation Syndrome underlies the occurrence of intra- and post-operative cardiorespiratory and vascular instability associated with the use of methacrylate bone cement in orthopedics. These findings have been referred to as the bone cement implantation syndrome (BCIS).
Triggers:
(1) surgical bone marrow damage, with release of cellular debris and fat microemboli
(2) cellular toxicity caused by monomeric methyl methacrylate, with release of cellular debris
(3) methacrylate microparticles in the circulation
Hypercoagulable state:
(1) activation of coagulation with increased release of thrombin and fibrin split products
(2) venous thromboembolism
(3) fibrin thrombi
Clinical manifestations of the bone cement implantation syndrome:
(1) respiratory distress
(2) cardiac arrhythmias
(3) heart failure
(4) angina
(5) myocardial infection
(6) altered mental status
(7) paresis
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