AB146. 238. Bone cement implant syndrome awareness

Background: Bone cement implant syndrome (BCIS) is a risk for patients who undergo cemented hip arthroplasty, and its prevalence remains high, in particular for cemented hemiarthroplasty following neck of femur fracture. The establishment of a grading system for BCIS in 2009 allows for measurement and its use has demonstrated the severity of this syndrome and its implications for patients and surgical teams. The ability of the surgical and anesthetic team to manage this potentially fatal condition hinges on awareness and preparation. The goal of the study was to determine the levels of awareness of BCIS in a cohort of orthopaedic and anesthetic teams.

Methods: A survey was conducted which consisted of 10 questions, each aimed at determining the surgeons’ and anesthetists’ familiarity with BCIS its clinical management. 65 surveys were completed, with responders ranging from intern to consultant level. Results are presented as percentage of total cohort surveyed as well as percentage of subgroup surveyed (Intern, SHO, Registrar and Consultant).

Results: The results highlight a concerning disparity in awareness of the condition among trainees and consultants. All the consultants surveyed were aware of BCIS and reported previous first-hand experience with it. Many of the lower grades were much less aware both of the condition itself and of practical steps to manage the syndrome if encountered. For those who had patients who experienced BCIS following cemented hip arthroplasty, many remarked that there was significant morbidity frequently associated with its presentation in their experience. Those who reported a direct first-hand experience reported a significant morbidity associated with the syndrome.

Conclusions: This survey highlighted the need for increased formal training of Orthopaedic and Anaesthetic trainees with respect to the awareness and management of BCIS. Adequate training could reduce the frequently catastrophic patient outcomes associated with BCIS.

Keywords: Arthroplasty; orthopaedics; anaesthetics