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01-04-2021 | Original Paper

Cemented stems in healthy elderly patients result in higher hypoxia despite a paradoxical lower femoral increase of intramedullary pressure

Authors: Skender Ukaj, Matjaž Veslko, Shaip Krasniqi, Vlora Podvorica, Fatime Ukaj, Arben Ahmeti, Philippe Hernigou, Matej Cimerman

Published in: International Orthopaedics | Issue 4/2021

Abstract

Purpose

Hypoxia is a well-known complication in cemented arthroplasty; however, it is not known whether the level of hypoxia is related to the intramedullary pressure or to the age of the patient; therefore, we studied the intramedullary pressure and level of hypoxia in patients undergoing cemented arthroplasty.

Methods

A prospective study was performed during cemented arthroplasties in 25 patients with an average age of 66.2 ± 12.1 years old. The intramedullary pressure (IMP) was measured by placing a pressure transducer within the bone while simultaneously measuring the pulse oximetry arterial oxygen saturation (SpO2), pulse, and blood pressure. These variables were obtained immediately after spinal anaesthesia, five minutes after cementation, and 15 minutes after prosthesis insertion.

Results

One hundred percent of patients had hypoxia at some level, but 83% of elderly patients (older than 66.5 years) had hypoxia (SpO2 <94%) as compared to only 23% of younger patients (p = 0.006). In the group of young patients, IMP was roughly increased 32 times as compared with baseline level, with as consequences a decrease of 4% of SpO2 (from 98.3 to 94.15%); in the elderly group, the IMP was only increased 20 times, but a decrease of 6% of SpO2 (from 97.25 to 91%) was observed.

Conclusions

This series demonstrated higher hypoxia in elderly healthy patients despite a paradoxical lower femoral increase of intramedullary pressure as compared with younger patients. This hypoxia is probably not only related to the cement but also to the patient’s age with decline of maximum oxygen uptake capacity and increase bone porosity.

Clinical trials

ClinicalTrials.gov Identifier: NCT03930537 https://clinicaltrials.gov/ct2/show/NCT03930537

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Title: Cemented stems in healthy elderly patients result in higher hypoxia despite a paradoxical lower femoral increase of intramedullary pressure
Authors: Skender Ukaj
Matjaž Veslko
Shaip Krasniqi
Vlora Podvorica
Fatime Ukaj
Arben Ahmeti
Philippe Hernigou
Matej Cimerman
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 4/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-021-04955-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cemented stems in healthy elderly patients result in higher hypoxia despite a paradoxical lower femoral increase of intramedullary pressure

Abstract

Purpose

Methods

Results

Conclusions

Clinical trials

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Clinical trials

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