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1.
Chinese Journal of Industrial Hygiene and Occupational Diseases ; (12): 396-400, 2022.
Artículo en Chino | WPRIM | ID: wpr-935820

RESUMEN

There are many occupational risk factors in operating room work. Polymethyl methacrylate (PMMA) , as a kind of common bone filling and repairing material, is widely used in the fixation of artificial joints, oral braces and orthopedic prosthesis. However, PMMA will release methyl methacrylate (MMA) monomer when it is implanted into human tissues and polymerized to harden, which is toxic to the body. This paper analyzes harmful factors in using PMMA bone cement, and then explores corresponding occupational protection knowledge, in order to reduce the occurrence of occupational hazards related to PMMA bone cement and enhance the self-protection ability of the operation room medical staff.


Asunto(s)
Humanos , Cementos para Huesos/efectos adversos , Quirófanos , Polimetil Metacrilato/efectos adversos
2.
Clinics in Orthopedic Surgery ; : 237-242, 2016.
Artículo en Inglés | WPRIM | ID: wpr-216513

RESUMEN

BACKGROUND: To augment cement-bone fixation, Dr. Hironobu Oonishi attempted additional physicochemical bonding through interposition of osteoconductive crystal hydroxyapatite (HA) granules at the cement-bone interface in 1982. He first used the interface bioactive bone cement (IBBC) technique in 12 selected patients (12 hips) in 1982 (first stage) and followed them for 2 years. In 1985, the technique was applied in 25 total hip arthroplasty (THA) patients (second stage) and the effects were investigated by comparing the side with the IBBC technique and the other side without the IBBC technique. He has employed this technique in all THA patients since 1987 (third stage). METHODS: In the IBBC technique, HA granules (2 to 3 g) were smeared on the bone surface just before the acetabular and femoral components were cemented. In the first stage, 12 hips were operated using the IBBC technique in 1982. In the second stage, THA was performed without the IBBC technique on one side and with the IBBC technique on the other side within 1 year in 25 patients. In the third stage, THA was performed with the IBBC technique in 285 hips in 1987. RESULTS: In the first stage patients, implant loosening was not detected at 30 years after operation. In the second stage patients, revision was required in 7 hips without the IBBC technique due to cup loosening (5 hips) and stem loosening (2 hips), whereas no hip was revised after THA with the IBBC technique at 26 years after operation. In the third stage patients, the incidence of radiolucent lines and osteolysis was very few at 25 years after operation. CONCLUSIONS: The long-term follow-up of THA performed around the inception of the IBBC technique has revealed low incidences of radiolucent lines, osteolysis, and revision surgery.


Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad , Adulto Joven , Artroplastia de Reemplazo de Cadera/efectos adversos , Cementos para Huesos/efectos adversos , Interfase Hueso-Implante/fisiología , Estudios de Seguimiento , Cadera/diagnóstico por imagen , Hidroxiapatitas/uso terapéutico
3.
Clinics in Orthopedic Surgery ; : 49-55, 2014.
Artículo en Inglés | WPRIM | ID: wpr-68302

RESUMEN

BACKGROUND: Vertebroplasty is not free from cement related complications. If an allograft is used as a filler, most of them can be averted. METHODS: Forty consecutive cases of osteoporotic vertebral fracture were divided into two groups by self-selection. The study and the control groups underwent vertebroplasty with fresh frozen allogeneic bone chips and bone cement, respectively. Clinical results were assessed at preoperation, postoperative day 1 and months 3, 6, and 12 by 10-grade visual analog scale (VAS), and radiological results were assessed at the same time by vertebral kyphotic angle (VKA) and local kyphotic angle (LKA). The results were compared within and between the groups. Survival function was analyzed. The criteria of an event were clinical or radiological deterioration versus pre-index surgery state. RESULTS: VAS was improved in the study group from 8.4 +/- 0.8 to 5.2 +/- 1.4, 6.4 +/- 1.2, 5.5 +/- 2.7, and 3.7 +/- 1.4 at postoperative day 1 and months 3, 6, and 12, respectively, and in the control group from 8.4 +/- 1.2 to 3.2 +/- 1.1, 3.2 +/- 1.7, 3.2 +/- 2.7, and 2.5 +/- 1.7, respectively (within group, p < 0.001; between groups, p < 0.001). VKA was improved in the study group from 18.9degrees +/- 8.0degrees to 15.2degrees +/- 6.1degrees (p = 0.046) and in the control group from 14.7degrees +/- 5.2degrees to 10.3degrees +/- 4.7degrees (p < 0.001) at postoperative day 1. LKA was not improved in the study group but was improved in the control group from 16.8degrees +/- 11.7degrees to 14.3degrees +/- 9.6degrees (p = 0.015). Correction angle was 2.7degrees +/- 4.6degrees, -7.9degrees +/- 5.3degrees, -7.2degrees +/- 5.2degrees, and -7.4degrees +/- 6.3degrees at postoperative day 1 and months 3, 6, and 12, respectively, in the study group and 4.3degrees +/- 3.7degrees, 0.7degrees +/- 3.6degrees, 0.7degrees +/- 4.2degrees, and 0.1degrees +/- 4.4degrees, respectively, in the control group. Correction loss was significant in both groups (p < 0.001) and more serious in the study group (p < 0.001). The 6-month survival rate was 16.7% in the study group and 64.3% in the control group (p = 0.003; odds ratio, 5.250). CONCLUSIONS: In treatment of osteoporotic vertebral fracture, fresh frozen allogeneic bone chips are not recommendable as a filler for its worse results than bone cement.


Asunto(s)
Anciano , Femenino , Humanos , Masculino , Cementos para Huesos/efectos adversos , Sustitutos de Huesos/efectos adversos , Estudios de Casos y Controles , Fracturas Osteoporóticas/epidemiología , Dimensión del Dolor , Trasplante Homólogo/efectos adversos , Vertebroplastia/efectos adversos
4.
Korean Journal of Radiology ; : 443-447, 2014.
Artículo en Inglés | WPRIM | ID: wpr-109968

RESUMEN

We report a case of pulmonary bone cement embolism in a female who presented with dyspnea following multiple sessions of vertebroplasty. She underwent spectral CT pulmonary angiography and the diagnosis was made based on enhanced visualization of radiopaque cement material in the pulmonary arteries and a corresponding decrease in the parenchymal iodine content. Here, we describe the CT angiography findings of bone cement embolism with special emphasis on the potential benefits of spectral imaging, providing additional information on the material composition.


Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Angiografía/métodos , Cementos para Huesos/efectos adversos , Disnea/etiología , Hipotensión/etiología , Pulmón/diagnóstico por imagen , Arteria Pulmonar/diagnóstico por imagen , Embolia Pulmonar/etiología , Tomografía Computarizada por Rayos X/métodos , Vertebroplastia
5.
Korean Journal of Radiology ; : 451-454, 2013.
Artículo en Inglés | WPRIM | ID: wpr-218254

RESUMEN

A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.


Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Adenocarcinoma/secundario , Cementos para Huesos/efectos adversos , Embolia/etiología , Vena Ilíaca , Vértebras Lumbares/cirugía , Neoplasias Pulmonares/patología , Embolia Pulmonar/prevención & control , Neoplasias de la Columna Vertebral/secundario , Filtros de Vena Cava , Vena Cava Inferior , Trombosis de la Vena/diagnóstico por imagen , Vertebroplastia/efectos adversos
6.
Artículo en Español | LILACS, BINACIS | ID: biblio-1170947

RESUMEN

Vertebroplasty is a minimally invasive technique for the treatment of osteoporotic fractures. Within its complications is pulmonary embolism, which can be asymptomatic or with respiratory distress and may be notes by radiography or computed tomography. At present there is no guide to indicate the routine performance of imaging techniques after treatment, and all agreed on the need to start anticoagulant therapy for 3 months or so with coumarin in symptomatic or asymptomatic central emboli.


Asunto(s)
Embolia Pulmonar/diagnóstico por imagen , Vertebroplastia/efectos adversos , Anticoagulantes/uso terapéutico , Cementos para Huesos/efectos adversos , Embolia Pulmonar/etiología , Embolia Pulmonar/tratamiento farmacológico , Femenino , Humanos , Osteoporosis/complicaciones , Persona de Mediana Edad
9.
Journal of Korean Medical Science ; : 301-303, 2011.
Artículo en Inglés | WPRIM | ID: wpr-123274

RESUMEN

Although drug fever may develop after administration of the drug by various routes, it has not been reported with antibiotic-loaded bone cement. Here, a case of drug fever induced by piperacillin/tazobactam loaded into bone cement is reported. A 72-yr-old woman presented with fever that developed two weeks after insertion of bone cement loaded with antibiotics including piperacillin/tazobactam into the knee joint for infectious arthritis. The fever was associated with a skin rash and blood eosinophilia. The work-up of the fever excluded several causes. Drug provocation test demonstrated that the piperacillin/tazobactam, which had been loaded in the bone cement, was the cause of the fever. The findings of this case suggest that drug fever can be induced by any drug placed and released continuously within the body. Therefore, the evaluation for possible drug fever should include all drugs the patient has been exposed to regardless of the route of administration.


Asunto(s)
Anciano , Femenino , Humanos , Antibacterianos/efectos adversos , Artritis/tratamiento farmacológico , Cementos para Huesos/efectos adversos , Quimioterapia Combinada , Inhibidores Enzimáticos/efectos adversos , Fiebre/inducido químicamente , Ácido Penicilánico/efectos adversos , Piperacilina/efectos adversos
10.
Rev. Asoc. Argent. Ortop. Traumatol ; 75(2): 125-130, jun. 2010.
Artículo en Español | LILACS | ID: lil-559329

RESUMEN

Introduccion: Se ha demostrado que la disminución dela presión arterial media (PAM) produce un efectohemostático en el conducto endomedular. En relación con la calidad del cementado en las artroplastias, no se han hallado publicaciones que correlacionen in vivo los valores de PAM y los defectos de cementación. Se diseñó un estudio de corte transversal de correlación con el objetivo de investigar la posible asociación entreestos dos factores. Materiales y métodos: Se seleccionaron 56 pacientes sometidos a artroplastias primarias de cadera, de acuerdo con un muestreo por conveniencia. Los valores de presión arterial media durante el cementado se obtuvieron mediante la revisión de los monitoreos anestésicos intraoperatorios. Se consideraron defectos de cementado las burbujas y radiolucencias presentes en la interfaz hueso-cemento. Se efectuaron cálculos de regresión con el método de Spearman entre ambas variables. Resultados: La cantidad de burbujas encontradas por región femoral no se correlacionó con la PAM, R2 = 0,02 (p > 0,05). Se observó una asociación estadísticamente significativa entre la mayor cantidad de radiolucencias en el manto de cemento y los mayores valores de PAM, R2 = 0,7 (p < 0,05). Conclusiones: Se ha logrado establecer una correlación lineal entre la aparición de defectos del cementado en forma de radiolucencias y los valores de la PAM. En cuanto a los defectos denominados burbujas, no seobservó tal correlación.


Asunto(s)
Humanos , Artroplastia de Reemplazo de Cadera/efectos adversos , Presión Sanguínea , Cementos para Huesos/efectos adversos , Articulación de la Cadera/cirugía , Fémur/cirugía , Complicaciones Intraoperatorias , Factores de Tiempo
11.
Yonsei Medical Journal ; : 466-468, 2010.
Artículo en Inglés | WPRIM | ID: wpr-114979

RESUMEN

Polymethl methacrylate (PMMA) screw reinforcement is frequently used in osteoporotic bone as well as in damaged pilot holes. However, PMMA use can be dangerous, since the amount of applied cement is uncontrolled. A 47-year-old male with traumatic cervical spondylolisthesis at C6-7 underwent anterior cervical plate fixation. During repeated drilling and tapping for false trajectory correction, a pilot hole was damaged. Although it was an unconventional method, PMMA augmentation was tried. However, PMMA was accidentally injected to the cervical spinal cord owing to lack of fluoroscopic guidance. The PMMA was surgically removed after corpectomy and durotomy. The patient had left side hemiparesis (Grade 2/5) immediately post operation. The patient improved spontaneously (Grade 4/5) except for 4th and 5th digit extension. Here, we report a rare complication of PMMA extrusion in the spinal cord during a damaged pilot hole injection, which has not previously been described.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Cementos para Huesos/efectos adversos , Tornillos Óseos , Vértebras Cervicales/cirugía , Polimetil Metacrilato/efectos adversos
13.
Clinics ; 60(6): 439-444, Dec. 2005. ilus, graf
Artículo en Inglés | LILACS | ID: lil-418488

RESUMEN

OBJETIVO: O tratamento com curetagem cauterização e metilmetacrilato de lesões ósseas benignas agressivas é o método agora amplamente aceito em quase todos os Centros Ortopédicos Oncológicos, entretanto uma das controvérsias com relação a esta técnica são as possíveis complicações que podem sugerir com o uso do metilmetacrilato fazendo com que alguns autores o removam dos anos depois da cirurgia e os substituam com o enxerto ósseo. O objetivo deste trabalho é apresentar a avaliação radiográfica e funcional de 214 pacientes apresentando lesões ósseas benignas agressivas tratadas com curetagem, cauterização e metilmetacrilato de 1974 a 1998, sendo que alguns deles tem 12 anos de seguimento. Esses pacientes foram avaliados clínica e radiograficamente para a ocorrência de osteoartrose tardia, amplitude de movimento e dor na articulação envolvida. MÉTODO: Este estudo é constituído de 214 pacientes, com seguimento médio de 10,6 anos (2 a 24 anos). Todos os casos correspondem as lesões benignas agressivas. Os pacientes foram avaliados de acordo com Muscolskeletal Tumor Society Score sendo descritas as complicações. RESULTADOS: A avaliação funcional da (MSTS) foi excelente em 166 casos (78%), bom em 26 (12%), regular em 11(5%) e mal 11 (5%). Foram observadas as seguintes complicações: osteoartrose tardia 25 casos (12%), infecção 12(6%), fratura patológica 11(5%) e rescindiva local 19(9%). CONCLUSÃO: Baseado na abordagem clínica não foi observado efeitos deletérios diretamente relacionados ao uso do metilmetacrilato. A avaliação funcional realizada em 1998 (até 24 anos de seguimento) não apresentou alterações significantes quando comparadas a avaliação realizada em 1985.


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto , Legrado , Cementación/efectos adversos , Metilmetacrilato/efectos adversos , Neoplasias Óseas/terapia , Complicaciones Posoperatorias , Tumores de Células Gigantes/terapia , Cauterización , Cementos para Huesos/efectos adversos , Estudios de Seguimiento , Neoplasias Óseas/fisiopatología , Neoplasias Óseas , Resultado del Tratamiento , Tumores de Células Gigantes/fisiopatología , Tumores de Células Gigantes
14.
Rev. mex. ortop. traumatol ; 13(6): 630-2, nov.-dic. 1999. tab
Artículo en Español | LILACS | ID: lil-276551

RESUMEN

Se presenta una serie de 20 casos operados con prótesis de Wagner, 8 por coxartrosis con otra prótesis primaria y fractura sobre la prótesis y 12 por fractura tratada con osteosíntesis primaria fallida, habiendo obtenido en todos buen resultado como tratamiento definitivo a la complicación previa. Sólo hubo un caso de luxación de la prótesis de Wagner, tratado mediante manipulación cerrada. El resultado general fue satisfactorio gracias a la longitud del vástago femoral que va de 190 a 305 milímetros


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/terapia , Cementos para Huesos/efectos adversos , Dispositivos de Fijación Ortopédica , Prótesis de Cadera/efectos adversos , Prótesis e Implantes , Osteoartritis de la Cadera/cirugía , Osteoartritis de la Cadera/complicaciones , Osteoartritis de la Cadera/terapia , Fracturas de Cadera/complicaciones , Fracturas de Cadera/terapia
15.
Rev. mex. ortop. traumatol ; 7(6): 271-8, nov.-dic. 1993. tab
Artículo en Español | LILACS | ID: lil-135029

RESUMEN

Se hace una revisión bibliográfica de las publicaciones más relevantes, que contienen material acerca de artroplastia total de cadera cementada, en relación con el aflojamiento aséptico. Se agrupan los mecanismos de falla artroplástica en: fallas biológicas y mécanica; así como en temprana y tardía. Se revisa también el papel que juega el paciente, el tipo de implante y el cirujano. Se elabora un fluxograma que integra todos los mecanismos posibles de la falla


Asunto(s)
Humanos , Cementos para Huesos/efectos adversos , Metilmetacrilatos/efectos adversos , Prótesis de Cadera/instrumentación , Prótesis e Implantes , Cementos para Huesos/análisis , Cadera/cirugía , Metilmetacrilatos/uso terapéutico , Prótesis de Cadera/efectos adversos
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