Patients who undergo joint replacement surgeries involving bone cement have reported serious complications.
Bone cement may fragment, causing joint implants to destabilize. It may also cause fat, bone marrow, and cement to leak into the bloodstream.
Bone cement is typically used to secure hip and knee replacements to bones. Some patients have complained that the material fragmented, causing their prosthetics to loosen and debond.
Bone cement is also linked to a potentially life-threatening condition called bone cement implantation syndrome, or BCIS. A patient who suffers from BCIS will experience side effects—like hypoxia and pulmonary embolism—almost immediately, within minutes from the cement coming in contact with the bone.
Patients and their loved ones who suffered from BCIS and other bone cement complications are now filing lawsuits against manufacturers for failing to warn of the product’s health risks.
What is Bone Cement?
Bone cement is used in joint replacement surgeries, particularly those involving hips and knees. The cement is applied between the prosthetic and the bone to help secure implants and keep them in place.
Bone cement may also be inserted directly into the bone to help repair microfractures and bone loss. Calcium-based bone cement is used to mimic lost bone.
The most common type of bone cement is polymethyl methacrylate (PMMA)—the same chemical that makes plexiglass.
There are multiple types of bone cement. The most common is polymethyl methacrylate (PMMA), the same chemical that makes plexiglass. Glass polyalkenoate, magnesium phosphate, and calcium phosphate bone cements are also used, the latter primarily for craniofacial and microfracture surgeries. Antibiotics are also typically added to bone cement to help prevent infection once applied to the bone.
Bone cement is prepared during medical procedures by medical professionals. Liquid and powder-like substances are combined, typically by hand or sometimes with vacuum technology, to create a wet mixture that gradually hardens. Medical staff have to carefully monitor preparation, as factors like the room temperature and mixing speed can affect the consistency of the bone cement.
High-viscosity cement (HVC) can be prepared in a shorter amount of time, however, it may not be as strong as other bone cement varieties.
What Are the Possible Adverse Effects of Bone Cement?
Patients and medical professionals have reported the following adverse effects associated with bone cement:
Loosening of joint implant
Bone cement, particularly high-viscosity cement, can fragment, causing implants to loosen and debond. This can cause instability, unusual swelling at the joint site, decreased range of motion, and persistent pain.
Many patients have filed lawsuits over DePuy’s ATTUNE knee replacement for this problem.
Bone cement leakage
When bone cement is inserted directly into the bone, it can sometimes leak from the needle into surrounding soft tissue, veins, and along spinal nerves, sometimes resulting in nerve damage.
In joint replacement procedures, the bone cement can create enough pressure to the bone that bone marrow, fat, and the cement can enter the bloodstream, clogging arteries.
Bone cement implantation syndrome (BCIS)
This rare but potentially life-threatening complication may cause oxygen deficiency, low blood pressure, pulmonary embolism, cardiac arrest, and / or unexpected loss of consciousness.
What is Bone Cement Implantation Syndrome?
Pressure from bone cement can cause fat, bone marrow, and even cement to leak into the bloodstream.
Some patients who undergo surgeries involving bone cement may suffer from bone cement implantation syndrome (BCIS). This complication is most commonly associated with hip replacements, but it can happen during any procedure.
When bone cement is applied between the bone and the artificial joint, it expands and puts pressure on the bone. This pressure can cause fat, bone marrow, and even cement to leak into the bloodstream. These materials can clog arteries and cause the patient to suffer from pulmonary embolism or cardiac arrest.
Common BCIS symptoms include oxygen deficiency, low blood pressure, and / or unexpected loss of consciousness.
The U.S. Food and Drug Administration (FDA) identified BCIS as a health risk associated with bone cement in 2002.
Between 2005 and 2012, 62 patients suffered from BCIS in England and Wales alone. Forty-one of these cases were fatal, with 80% of the deaths occurring during the procedure.
What Causes BCIS?
The causes of BCIS are still being researched. However, it’s believed that it may be a symptom of pressure applied to the bone. Pressure builds when the cement expands between the bone and the prosthesis, reaching temperatures as high as 96 degrees celsius.
This pressure is thought to cause blood vessels within the bone to rupture, and bone marrow, fat, cement particles, to enter the bloodstream.
One study found that when a suction catheter was placed in the femur to reduce this pressure, it significantly decreased the likelihood of the patient suffering from blood clots and / or other embolic events. In conventional bone cement hip replacement procedures, 93.4% of patients suffered from an embolic event, compared to 13.4% of patients who underwent a procedure using the catheter.
What Are the Risk Factors for BCIS?
Patients with the following conditions may be more susceptible to developing BCIS:
- Old age
- Impaired heart and lung function
- Pulmonary hypertension
- Bone metastases (cancer of the bones)
- Multiple hip fractures
Did You Suffer From Bone Cement Complications?
If you or a loved one suffered from complications during or after a bone cemented joint replacement surgery or other procedure involving bone cement, you may be eligible to file a lawsuit. A bone cement lawsuit can help recover compensation for medical bills, loss of wages, pain and suffering, and more.
Find out if you have a case for free simply by completing this form. If you choose to file a lawsuit, you won’t pay a thing unless we win a jury verdict or settlement for you.