Case reports: polymethylmethacrylate lung embolus after limb-salvage surgery of the distal femur

Clin Orthop Relat Res. 2006 Jul:448:252-6. doi: 10.1097/01.blo.0000223973.68218.10.

Abstract

Limb-salvage surgery for malignant tumors frequently involves reconstruction with an endoprosthesis anchored to bone by using third-generation cementing techniques. A 10-year-old boy with osteosarcoma had a pulmonary embolus caused by polymethylmethacrylate after having limb-salvage surgery that used high-pressure cementing techniques. He experienced transient postoperative chest pain, and a new wedge-shaped radiodense pulmonary lesion appeared on a computed tomography scan of the chest. A thoracotomy for resection of suspected metastatic osteosarcoma revealed a pulmonary infarct caused by cement embolization. Awareness of this potential complication should prompt investigation of possible pulmonary embolism and may prevent unnecessary thoracotomy.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biopsy
  • Bone Cements / adverse effects*
  • Bone Cements / therapeutic use
  • Child
  • Diagnosis, Differential
  • Fatal Outcome
  • Femoral Neoplasms / diagnosis
  • Femoral Neoplasms / surgery*
  • Humans
  • Limb Salvage / adverse effects*
  • Limb Salvage / methods
  • Male
  • Osteosarcoma / diagnosis
  • Osteosarcoma / surgery*
  • Polymethyl Methacrylate / adverse effects*
  • Polymethyl Methacrylate / therapeutic use
  • Pulmonary Embolism / chemically induced*
  • Pulmonary Embolism / diagnosis
  • Tomography, X-Ray Computed

Substances

  • Bone Cements
  • Polymethyl Methacrylate