{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:59:27Z","timestamp":1790103567381,"version":"4.0.1"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Cardiac arrest during hip or knee arthroplasty (KA) represents the most severe manifestation of bone cement implantation syndrome (BCIS). However, true incidence rates remain uncertain, and data on clinical characteristics and outcomes are limited. The aim of this study was to determine the incidence of BCIS grade 3 in hip and KA and to describe associated clinical characteristics and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective multicenter case series included all hip and KA procedures performed at 4 Dutch hospitals. Potential cases were identified through database queries. Medical records were manually reviewed to confirm BCIS grade 3, defined as cardiovascular collapse requiring cardiopulmonary resuscitation occurring from joint manipulation through skin closure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>No cases of BCIS grade 3 occurred during 25,914 knee arthroplasties. Among 39,237 hip procedures, 31 patients experienced BCIS grade 3 (0.08%), of which 27 cases occurred during hemiarthroplasty for femoral neck fracture (FNF). The mean age of patients with BCIS grade 3 was 86.2 \u00b1 7.7 years; 71.0% were female, 93.5% underwent acute surgery for FNF, 87.1% involved cemented procedures, and perioperative mortality was 67.7%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>BCIS grade 3 is rare but highly lethal, occurring predominantly during hemiarthroplasty for FNF in elderly patients. Individualized risk assessment and informed consent are essential when managing FNF in high-risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.oa.26.00252","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:01:35Z","timestamp":1790100095000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The Incidence of Bone Cement Implantation Syndrome Grade 3 in Hip and Knee Arthroplasty: A Retrospective Multicenter Case Series"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6631-0724","authenticated-orcid":false,"given":"Karen E.","family":"Brokke","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Spaarne Gasthuis Academy, Hoofddorp, The Netherlands"},{"name":"Department of Anaesthesia, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6934-1781","authenticated-orcid":false,"given":"Sjoerd","family":"Servaas","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Spaarne Gasthuis Academy, Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0924-9358","authenticated-orcid":false,"given":"Inger N.","family":"Sierevelt","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Spaarne Gasthuis Academy, Hoofddorp, The Netherlands"},{"name":"Department of Orthopaedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands"},{"name":"Department of Orthopaedic Surgery, Xpert Clinics, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3001-1328","authenticated-orcid":false,"given":"Karel W.J.","family":"Klop","sequence":"additional","affiliation":[{"name":"Department of Surgery, Spaarne Gasthuis Academy, Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sef J.A.","family":"van Bilsen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurens","family":"Kaas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, St. Antonius Hospital, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loes W.A.H.","family":"van Beers","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, St. Antonius Hospital, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3440-4670","authenticated-orcid":false,"given":"Erik H.P.A.","family":"van Dongen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, St. Antonius Hospital, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rutger","family":"van Geenen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Anton","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Amphia Hospital, Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Koenraadt-van Oost","sequence":"additional","affiliation":[{"name":"Foundation for Orthopaedic Research, Care & Education Amphia Hospital, Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0812-5089","authenticated-orcid":false,"given":"Monique A.H.","family":"Steegers","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7474-2715","authenticated-orcid":false,"given":"Peter A.","family":"Nolte","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Spaarne Gasthuis Academy, Hoofddorp, The Netherlands"},{"name":"Department of Oral Cell Biology, Academic Centre for Dentistry, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7]]},"reference":[{"issue":"1","key":"R1-20260922","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/bja\/aen328","article-title":"Bone cement implantation syndrome","volume":"102","author":"Donaldson","year":"2009","journal-title":"Br J Anaesth."},{"issue":"4","key":"R2-20260922","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/j.bja.2025.05.041","article-title":"Bone cement implantation syndrome: a scoping review","volume":"135","author":"Brokke","year":"2025","journal-title":"Br J Anaesth."},{"issue":"8","key":"R3-20260922","doi-asserted-by":"crossref","first-page":"S353","DOI":"10.1016\/j.arth.2025.01.039","article-title":"Is bone cement implantation syndrome actually caused by cement? A systematic review of the literature using the Bradford-Hill criteria","volume":"40","author":"Barakat","year":"2025","journal-title":"J Arthroplasty."},{"issue":"1","key":"R4-20260922","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s12871-018-0526-4","article-title":"Evaluation of hemodynamic goal-directed therapy to reduce the incidence of bone cement implantation syndrome in patients undergoing cemented hip arthroplasty - a randomized parallel-arm trial","volume":"18","author":"Kaufmann","year":"2018","journal-title":"BMC Anesthesiol."},{"issue":"11","key":"R5-20260922","first-page":"e31908","article-title":"Bone cement implantation syndrome: incidence and associated factors in a United States setting","volume":"14","author":"Jaffe","year":"2022","journal-title":"Cureus."},{"issue":"2","key":"R6-20260922","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1007\/s00068-020-01587-8","article-title":"Bone cement implantation syndrome in cemented hip 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