**2. Bone cement**

Bone cement is a chemical substance consisting of methyl methacrylate polymers, which tightly adheres prosthetic material to the patient's bone by filling in the slots of the spongiosa. The exothermic reaction followed by the placement of the cement causes the cement to harden and expand. As a result, a pressure greater than 500 mmHg is seen in the bone medullary. This pressure causes fat, bone marrow and air embolism in femoral deep veins. In addition, residual methyl methacrylate monomers cause vasodilatation and reduce systemic vascular resistance. Release of tissue thromboplastin triggers platelet aggregation that leads to micro thrombus formation in the lungs and cardiovascular instability due to vasoactive substances in circulation [2].

Clinical signs of complication related to bone cement are as follows:


die in a year. In addition to osteoporosis, hip fractures due to bone metastases are too high to be neglected. Current treatment is to provide patient weight bearing as soon as possible.

• Pain due to activation of pain receptors by cytokines (prostaglandin, etc.), released by os-

• Bone marrow suppression due to medulla spinalis pressure and bone marrow infiltration

Non-surgical treatment is only available to patients with poor general conditions that are too low to tolerate any of the anesthetic methods. Hip fracture treatment requires a treatment choice, which needs to be individualized at the highest level. The choice of treatment should be based on surgeon, type of fracture, patient's age and health status. In an elderly patient population, hip fractures due to falling are among the first causes of death. An important factor determining the mortality in these surgeries is an advanced age; 30% of these cases are

Bone cement is a chemical substance consisting of methyl methacrylate polymers, which tightly adheres prosthetic material to the patient's bone by filling in the slots of the spongiosa. The exothermic reaction followed by the placement of the cement causes the cement to harden and expand. As a result, a pressure greater than 500 mmHg is seen in the bone medullary. This pressure causes fat, bone marrow and air embolism in femoral deep veins. In addition,

Hemiarthroplasties and locked hip nails are the first surgical treatment methods [1].

The most common problems faced in clinical practice are as follows:

• Infiltration and compression in the nerve roots

• Periosteum stretching • Intramedullary hypoxia

50 Total Hip Replacement - An Overview

• Reflex muscle spasm

above 85 years of age.

• Perioperative bleeding

• Thromboembolism

**2. Bone cement**

• Pathological fracture formation

• Direct bone invasion and destruction

teoclasts due to bone destruction • Limitation of movement due to pain

Complications due to hip fracture operations:

• Bone cement implantation syndrome


Methods to reduce cement-related complications:

