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Although also described for certain spinal procedures, it is most commonly associated with cemented hip and knee arthroplasty and with cemented hemiarthroplasty following neck of femur fracture in particular.<\/jats:p><jats:p>Donaldson<jats:italic>et al<\/jats:italic>proposed the definition of BCIS as a syndrome \u201ccharacterized by hypoxia, hypotension or both and\/or unexpected loss of consciousness occurring around the time of cementation, prosthesis insertion, reduction of the joint or, occasionally, limb tourniquet deflation in a patient undergoing cemented bone surgery\u201d. Other features include increased vascular resistance, cardiac arrhythmias and cardiac arrest post cement use.<\/jats:p><jats:p>We describe a case of a patient who suffered a catastrophic reaction to cement during surgery for a comminuted proximal femoral fracture.<\/jats:p>","DOI":"10.1136\/bcr-2017-220158","type":"journal-article","created":{"date-parts":[[2017,9,23]],"date-time":"2017-09-23T09:05:13Z","timestamp":1506157513000},"page":"bcr-2017-220158","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Catastrophic cement reaction following cementation for megaprosthesis for proximal femoral fracture"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2355-225X","authenticated-orcid":false,"given":"Muhammad Nouman","family":"Baig","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Curtin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Andrew","family":"Callaghan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin G","family":"Murphy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,9,23]]},"reference":[{"key":"2025042712412593000_2017.sep21_1.bcr-2017-220158.1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen328"},{"key":"2025042712412593000_2017.sep21_1.bcr-2017-220158.2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00448957"},{"key":"2025042712412593000_2017.sep21_1.bcr-2017-220158.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)61121-5"},{"key":"2025042712412593000_2017.sep21_1.bcr-2017-220158.4","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/PL00021216","article-title":"Transesophageal echocardiography and clinical features of fat embolism during cemented total hip arthroplasty. 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