Methylmethacrylate blood levels in patients with femoral neck fracture

✍ Scribed by N. Svartling; P. Pfäffli; L. Tarkkanen

• Publisher: Springer
• Year: 1985
• Tongue: English
• Weight: 366 KB
• Volume: 104
• Category: Article
• ISSN: 1434-3916
• DOI: 10.1007/bf00450218

✦ Synopsis

The blood levels of monomeric methylmethacrylate were measured in 20 patients with fracture of the femoral neck, treated with a Thompson prosthesis under spinal anesthesia Monomeric methylmethacrylate was detected in the blood stream in all patients; the maximum levels (mean 6 44 p g/ ml, range 0 05-31 89 lig/ml) were measured 30 S after insertion of the Thompson prosthesis A moderate drop in systolic blood pressure and a marked reduction of arterial oxygen tension was noted after cementation and insertion of the prosthesis; the mean maximum drops were 10 1 mm Hg (range 0-32 mm Hg) and 6.1 mm Hg (range 0-13 5 mm Hg) No dose-dependent correlation could be established between the levels of monomeric methylmethacrylate and the drop in arterial blood pressure or arterial oxygen tension.

There have been many reports on peroperative complications during partial and total replacement of the hip joint in connection with the use of bone cement. Hypotension, hypoxemia, and, rarely, intraoperative deaths have been witnessed l 12, 14, 17,19 l These complications have been attributed to monomer intoxication, as monomeric methylmethacrylate (MMA) has been detected in the blood circulation coincident with cementation l 5 l Earlier reports are not unanimous in this respect, however, and other etiological factors have also been implicated in cardiac dysfunction l 4, 11, 12, 15, 18, 20, 21 l. Patients with fracture of the femoral neck occasionally seem to be susceptible to profound hemodynamic disorders coincident with cementation This