Bilateral Femoral Nutrient Foraminal Cement Penetration during Total Hip Arthroplasty-Abstract

What to Learn from this Article?

 1. What are the differential if you notice extra cortical cement around femoral shaft after THR?

 

2. Presentation and management of nutrient artery cement penetration?


 

Case Report

 Volume 2 | Issue 4 | JOCR Oct-Dec 2012 | Page 4-6


Authors: Ross Coomber [1], Rej S Bhumbra [2], Robert Marston [3]

[1]Department of Orthopaedic Surgery. Luton and Dunstable Hospital, Lewsey Road, Luton, UK
[2] London Sarcoma Service. Royal National Orthopaedic Hospital. Stanmore. London.
[3] Dept of Orthopaedics and Trauma. Bonney House. St. Mary’s Hospital.Imperial College of Medicine,Norfolk Place. Paddington. London. UK

Address of Correspondence: Dr Ross Coomber, Orthopaedic Specialty Registrar –Department of Orthopaedic Surgery. Luton and Dunstable Hospital, 38a Packington St, London, N1 8QB.United Kingdom. Email: rosscoomber@hotmail.com  


  Abstract

Introduction: Cement pressurisation is important for the insertion of both the acetabular and femoralcomponents during Total Hip Arthroplasty. Secondary to pressurization the rare phenomenon of unilateral cementincursion 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.

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

Conclusion: 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 total hip replacement. No such bilateral case has been reported.

 Keywords: Nutrient Foramen, Total Hip Arthroplasty, Cement, Polymethyl methacrylate.


How to Cite This Article: Coomber R, Bhumbra RS, Marston R. Bilateral Femoral Nutrient Foraminal Cement Penetration during Total Hip Arthroplasty. J Orthopaedic Case Reports 2012 Oct-Dec;2(4): 4-6.Available from: http://www.jocr.co.in/wp/wp-content/uploads/2013/01/jocr-oct-dec-2012-3-Bilateral-Femoral-Nutrient-Foraminal-Cement-Penetration-during-THA.pdf.


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