Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews最新文献

{"title":"Emergency Department Visits After Total Joint Arthroplasty in a Closed Urban Setting: A Report of 1,000 Consecutive Cases.","authors":"Julia Fisher, Lily Khabie, Ira H Kirschenbaum","doi":"10.5435/JAAOSGlobal-D-24-00252","DOIUrl":"10.5435/JAAOSGlobal-D-24-00252","url":null,"abstract":"<p><strong>Background: </strong>Rates of emergency department (ED) visits and readmissions after total joint arthroplasty (TJA) have been cited as indicators of TJA quality. Understanding the incidence and nature of these events is critical for prevention. The purpose of this study was to analyze readmission rates 30 and 90 days after TJA at a safety-net hospital in an urban setting and to compare this readmission rate with that for non-safety-net hospitals found in the current literature. In addition, we aimed to quantify the readmissions in our safety-net hospital that led to future complications. This would help us identify if there is a high incidence of preventable readmission rates in this unique socioeconomic environment.</p><p><strong>Methods: </strong>Using our institutional electronic medical record system, we retrospectively studied 1000 consecutive TJA encounters between 2014 and 2019 to determine the rates of treat-and-release ED visits within 30 and 90 days after surgery. The ED charts were reviewed, and patients who returned to the operating room (OR) for a TJA complication within 1 year of surgery were identified. We compared the OR return rates of people who had ED visits with those in the control group.</p><p><strong>Results: </strong>A total of 110 (11%) and 191 (19.1%) patients visited the ED within 30 and 90 days of surgery, respectively. Fisher exact test confirmed that having an ED visit within 90 days of TJA because of lower extremity pain and/or swelling or a social issue was associated with returning to the OR within a year of TJA. Having an ED visit within 30 or 90 days of total hip replacement was associated with returning to the OR for total hip replacement complications.</p><p><strong>Conclusion: </strong>ED visits after TJA at an urban safety-net hospital were markedly higher than those reported in the literature for nonurban safety-net hospitals. In addition, postoperative ED visits for specific diagnoses may predict complications. This indication may have implications for a risk adjustment in programs such as bundled payments. Our results also indicate overutilization of the ED by avoidable ED visits. This represents a call for alternatives to the ED for patients after TJA in environments served by safety-net hospitals.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amniotic Tissue Injections Are an Effective Alternative to Corticosteroid Injections for Pain Relief and Function in Patients With Severe Knee Osteoarthritis: A Double-Blind, Randomized, Prospective Study.","authors":"Stephan G Pill, Briggs Ahearn, John M Tokish, Chad Cook, Paul J Siffri, Jeremy J Mercuri, Brian Burnikel, Kyle J Cassas, Douglas J Wyland, Emily Sawvell, Noah Wright, Josh Hutchinson, Taylor Bynarowicz, Kyle J Adams, Michael J Kissenberth","doi":"10.5435/JAAOSGlobal-D-23-00276","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-23-00276","url":null,"abstract":"<p><strong>Introduction: </strong>The use of corticosteroid injections for short-term pain relief for knee osteoarthritis can have deleterious adverse effects. Amniotic tissue has shown promise in vitro; therefore, this study compared a morcellized injectable amniotic tissue allograft to corticosteroid injection.</p><p><strong>Methods: </strong>Eighty-one patients with symptomatic severe knee osteoarthritis (Kellgren-Lawrence grade 3 to 4) were prospectively randomized to either a double-blinded single injection of BioDRestore (Integra LifeSciences; n = 39) or triamcinolone acetonide (n = 42). Knee Injury and Osteoarthritis Outcome Score (KOOS), Single Alpha Numeric Evaluation, visual analog scale (VAS) pain, Lysholm Rating, and Veterans-Rand-12 scales at baseline, 6 weeks, 3, 6, and 12 months were analyzed.</p><p><strong>Results: </strong>No differences were observed in adverse reactions or patient reported outcomes (PROs); however, a notable continued improvement was found in the amnion group from 6 weeks to 1 year for Single Alpha Numeric Evaluation, Lysholm, and KOOS Symptoms, Pain, activities of daily living [ADL], QofL. The minimal clinically important difference (MCID) was met for Lysholm, KOOS ADL, and KOOS pain.</p><p><strong>Discussion: </strong>Both amnion and steroid injections showed an initial improvement in pain relief and function at 6 weeks; however, more patients in the amniotic tissue group maintained pain relief and function at the 1-year follow-up. The mixed results suggest that amniotic tissue injections may be a safe and effective alternative to corticosteroid injections.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Topographic Map of the Midfoot: Implication for Improving Safety of Dorsal Approach of Midfoot Surgeries.","authors":"Abdul Veli Ismailoglu, Umit Suleyman Sehirli, Dilruba Ayingen, Alp Bayramoglu, Cemre Savasan, Baris Kocaoglu","doi":"10.5435/JAAOSGlobal-D-24-00339","DOIUrl":"10.5435/JAAOSGlobal-D-24-00339","url":null,"abstract":"<p><strong>Purpose: </strong>The surgical approach for midfoot injuries classically requires dual dorsal incision and identification of the neurovascular structures that are susceptible to injury during the surgery. The aim of this study was to map the topographic anatomy of the dorsum of the foot along with tarsal joints for the dorsal approach of midfoot surgery that would facilitate the surgery and minimize the risk of neurovascular injuries for surgeons who specially focus on foot and ankle injuries.</p><p><strong>Methods: </strong>The dorsum of the foot was evaluated in 12 feet injected with latex containing a red colorant to visualize the arterial vessels. The navicular line, originating from the navicular tuberosity (NT) and passing over the dorsum of the foot, was used as a reference line. Dorsal foot neurovascular structures including cutaneous branches and muscles were mapped with respect to the tarsal joints and navicular line.</p><p><strong>Results: </strong>The deep peroneal nerve and dorsalis pedis artery were coursing between the base of the first and second metatarsal bones over which the tendon of the extensor hallucis brevis muscle was passing. The tendon of extensor hallucis brevis was crossing over the deep peroneal nerve and dorsalis pedis artery 55.2 mm superior and 45.0 mm lateral, respectively, from the NT.</p><p><strong>Conclusion: </strong>This cadaver study supplies a detailed topographic map of the dorsum of the foot using the tarsal joints and NT as landmarks for protecting the neurovascular structures to facilitate midfoot surgeries for sports medicine surgeons who specially focus on foot and ankle injuries.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11709205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Axial Rotation Between the Femoral Neck and Ankle Joint on Kinematics in Normal Knees: A Cross-Sectional Study.","authors":"Kenichi Kono, Shuji Taketomi, Takaharu Yamazaki, Tomofumi Kage, Masashi Tamaki, Hiroshi Inui, Sakae Tanaka, Tetsuya Tomita","doi":"10.5435/JAAOSGlobal-D-24-00169","DOIUrl":"10.5435/JAAOSGlobal-D-24-00169","url":null,"abstract":"<p><strong>Background: </strong>The effect of axial rotation between the femoral neck and ankle joint (total rotation [TR]) on normal knees is unknown. Therefore, this study aimed to investigate the TR effect on normal knee kinematics.</p><p><strong>Methods: </strong>Volunteers were divided into groups large (L), intermediate (I), and small (S), using hierarchical cluster analysis based on TR in the standing position. TR was measured using three-dimensional (3D) bone models generated from CT. A two-dimensional to 3-dimensional registration technique was used to assess the spatial position and femur and tibia orientation during squat. The axial rotation, varus-valgus alignment, and anterior-posterior translation of the femur relative to the tibia were evaluated.</p><p><strong>Results: </strong>Group L had the highest TR, whereas group S had the lowest TR (L: 36.6° ± 6.0°, I: 23.2° ± 3.0°, and S: 13.8° ± 5.1°). Above 50° of flexion, femoral external rotation was greater in group S than in groups L and I. From 40° to 110°, the medial side was more anterior in group L than in groups I and S, whereas the lateral side was more posterior in group S than in groups L and I.</p><p><strong>Conclusions: </strong>Individuals with larger TR had more femur anterior-medial translation relative to the tibia.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11709167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Cemented Hemiarthroplasty for Femoral Neck Fractures.","authors":"Sheena J Amin, John K Krumme, L Nathan Gause, Jonathan R Dubin, Akin Cil","doi":"10.5435/JAAOSGlobal-D-24-00183","DOIUrl":"10.5435/JAAOSGlobal-D-24-00183","url":null,"abstract":"<p><p>Geriatric femoral neck fractures are common orthopaedic injuries, which are associated with a high morbidity and mortality. Arthroplasty is the optimum treatment for many of these injuries, but debate exists regarding optimal surgical strategy. Multiple recent investigations have demonstrated strong superiority for cemented stems as compared with noncemented fixation with a decreased risk of periprosthetic fracture, shorter length of stay, lower cost, and decreased rate for revision surgery. The main purpose of this article is to refamiliarize the resident or practicing surgeon with cemented arthroplasty by reviewing the basic science of cement, common cementing concerns, and outcomes, as well as by providing tips on cementing technique to ensure safe, simple, and reproducible results.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of Available Treatments and Their Limitations for Hypertrophic Facet Joints-A Systematic Review of the Literature.","authors":"Noel Hawkins, Allison García, Fernando López-Candelas, David Salinas Aguirre, Onerys Sierra Trujillo, López Daniela Llerenas King, Lucia Elizabeth Álvarez-Palazuelos, Andrea Virginia Ruiz-Ramírez","doi":"10.5435/JAAOSGlobal-D-24-00140","DOIUrl":"10.5435/JAAOSGlobal-D-24-00140","url":null,"abstract":"<p><strong>Background: </strong>Physicians worldwide face the challenging task of improving patient satisfaction by reducing pain in injured patients. Currently, available therapeutic approaches provide only short-term relief of symptoms without addressing long-term satisfaction. This has led to exploring regenerative treatment options that can deliver better outcomes. One such promising option is platelet-rich plasma (PRP) injections, which are gaining popularity as an alternative to standard steroid injections.</p><p><strong>Objectives: </strong>This study examines the therapeutic effects of PRP injections in adult patients with stress or traumatic injuries.</p><p><strong>Methods: </strong>The systematic literature review yielded 60,301 articles, books, and websites verified and removed from the final project. The final studies used in the report comprised randomized trials, observational studies, and case reports on injecting biologics into the epidural space, facet joints, or sacroiliac joints. In total, 15 reviews and 13 studies were included in this review.</p><p><strong>Results: </strong>In the Wu et al study, 46 participants were randomly divided into group A (0.5 mL PRP injection) and group B (1.5 mL methylprednisolone injection). Although group B initially showed a notable pain reduction at one week, it diminished over 6 months, with group A consistently improving, reaching an 80.96% success rate and higher patient satisfaction. In the study by Singla et al comparing PRP (group P) and corticosteroid (group S) in 40 participants, PRP demonstrated a markedly greater reduction in VAS Scale at 6 weeks and 3 months, with a 90% effectiveness compared with 75% for steroids.</p><p><strong>Conclusion: </strong>PRP injections offer greater pain alleviation, disability reduction, and overall patient satisfaction improvements due to their effect on the immune response to promote the growth and proliferation of damaged tissue. It has also been shown to offer a safer alternative that carries fewer risks than that of transforaminal steroid injections due to promising clinical trials and scientific investigation outcomes. Several of the steroid injection studies proved to have mixed results and efficacy because patients reporting having similar pain relief with placebo groups that used saline injections. Further studies will be needed to evaluate PRP's long-term efficacy and cost-effectiveness for practical patient use in the future.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testosterone Replacement Therapy Is Associated With Increased Incidence Rate of Vertebral Fractures: A Matched Retrospective Analysis.","authors":"Manjot Singh, Mohammad Daher, Bassel G Diebo, Alan H Daniels, Michel A Arcand","doi":"10.5435/JAAOSGlobal-D-24-00248","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00248","url":null,"abstract":"<p><strong>Background: </strong>Whether testosterone replacement therapy (TRT) can mitigate the risk of vertebral fractures has not been well-studied.</p><p><strong>Methods: </strong>PearlDiver was queried to identify patients with and without the history of TRT. Groups were matched 1:1 by demographic variables and 2-year vertebral fracture incidence rate was compared. Multivariate logistic regression was done to identify independent predictors of vertebral fractures.</p><p><strong>Results: </strong>Among 77,491 matched patients, mean age was 54.7 ± 10.4 years, 74.3% were males, and mean Charlson Comorbidity Index was 0.17 ± 0.54. Testosterone replacement therapy patients had higher rates of vertebral fractures (0.31% vs 0.04%, P < 0.001), and these rates were observed to increase with age. Both men alone (0.36% vs 0.04%, P < 0.001) and women alone (0.16% vs 0.03%, P < 0.001) on TRT had higher rates of vertebral fractures. Multivariate analysis revealed that TRT (OR = 7.7, 95%CI = 5.1-11.7, P < 0.001), as well as chronic kidney disease (OR = 1.4, 95%CI = 1.1-2.0, P = 0.026), alcohol abuse (OR = 2.5, 95%CI = 1.8-3.5, P < 0.001), and diphosphonate use (OR = 2.2, 95%CI = 1.4-3.5, P < 0.001), increased vertebral fracture rates.</p><p><strong>Conclusions: </strong>Exogenous testosterone use was associated with increased 2-year incidence of vertebral fractures. Although a causal relationship could not be established, our findings highlight the need to use screening measures, such as dual-energy X-ray absorptiometry (DEXA) scan, to identify patients at risk of vertebral fractures.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Pressure Refrigerant Gas Injection Injury to the Hand.","authors":"Elizabeth Simmons, Alexandre Vesselle, Baris Yildirim, Blaine T Bafus","doi":"10.5435/JAAOSGlobal-D-24-00155","DOIUrl":"10.5435/JAAOSGlobal-D-24-00155","url":null,"abstract":"<p><p>High-pressure injection injuries, although rare, are commonly discussed orthopaedic surgical emergencies. In many cases, high-pressure injection injuries can have detrimental effects on the patient. However, there are rare instances where surgical intervention may be more harmful than helpful. Here, we present a case report of a patient who sustained a high-pressure chemical refrigerant injection injury into the palm of his hand working on an air conditioning refrigeration unit. He was treated nonsurgically with excellent outcomes. The aim of this case report was to bring awareness to the potential nonsurgical management of high-pressure injection injuries in select circumstances.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"After Anterior Cruciate Ligament Surgery, Variables Associated With Returning to the Same Surgeon If a Subsequent Antrior Cruciate Ligament Surgery Is Needed?","authors":"Scott J Halperin, Meera M Dhodapkar, William M McLaughlin, Estevao Santos, Michael J Medvecky, Jonathan N Grauer","doi":"10.5435/JAAOSGlobal-D-24-00349","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00349","url":null,"abstract":"<p><strong>Introduction: </strong>Anterior cruciate ligament reconstructions (ACLrs) unfortunately can require revision ACLr, or contralateral ACLr may be indicated (together subsequent ACLr). This study aimed to examine the rate of and factors associated with returning to the same surgeon.</p><p><strong>Methods: </strong>Patients who underwent ACLr and subsequent ACLr within 3 years were abstracted from the PearlDiver database. Patient factors and surgical factors were examined. Factors independently associated with changing the surgeon were examined.</p><p><strong>Results: </strong>Overall, 63,582 ACLr patients were identified with 2,823 (4.4%) having a subsequent ACLr. These subsequent ACLrs were performed by the same surgeon for 1,329 (47.1%) and by a different surgeon for 1,494 (52.9%). Factors independently associated with changing surgeons were 90-day adverse events after index surgery (odds ratio [OR] 1.95), longer time to second surgery (OR 1.61), and second surgery on the ipsilateral knee (OR 1.28). Notably, sex, comorbidity, depression, psychoses, and insurance plan were not correlated with choosing changing surgeons.</p><p><strong>Conclusion: </strong>Over half of the patients who required a subsequent ACLr changed surgeons. Changing surgeons was associated with adverse events after index surgery, ipsilateral revisions, longer time to surgery, and patient age. However, there should be confidence that the other assessed factors were not associated with the decision to change surgeons.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11692955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypermagnesemia- and Hyperphosphatemia-Associated Cardiac Arrest after Injection of a Novel Magnesium-Based Bone Cement in Spinal Surgery.","authors":"Jia Yi Loh, Zhixing Marcus Ling, Lei Jiang, Qing Yuan Goh, Yee Gen Lim","doi":"10.5435/JAAOSGlobal-D-24-00035","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00035","url":null,"abstract":"<p><p>We report a case of pulseless electrical activity (PEA) associated with profound hypermagnesemia immediately after cementation of a novel magnesium-based cement in spine surgery. During T8 to T12 posterior instrumentation and decompression laminectomy for vertebral metastasis secondary to lung cancer, a 61-year-old Chinese woman developed sudden hypotension and went into PEA immediately after injection of a novel magnesium-based cement. Intraoperative fluoroscopic imaging did not show any notable cement extravasation. Resuscitation using intravenous epinephrine with five doses of 1-mg epinephrine in 1:10,000 dilution was instituted, and the patient had return of spontaneous circulation after 5 minutes. After successful resuscitation, surgery was expedited and completed. Intraoperative and postoperative investigations were notable for profound hypermagnesemia and hyperphosphatemia requiring diuresis. No echocardiographic or computerized tomographic evidence of pulmonary embolism was found. The patient was transferred to the surgical intensive care unit and remained on dual inotropic support over the next few days. She subsequently weaned off inotropic support and electrolyte imbalances resolved before making a full recovery. This case report demonstrates the severe magnesium toxicity and PEA related to the use of novel magnesium-based cement in spine surgery. Further studies need to be conducted to understand the potential complications related to its use and compare them to the standard bone cement implantation syndrome.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11692957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}