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The Journal of Arthroplasty, ISSN: 0883-5403, Vol: 18, Issue: 1, Page: 113-120
Knee
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Paradoxic cerebral embolism after cemented knee arthroplasty:A report of 2 cases and prophylactic option for subsequent arthroplasty
Yeon, Howard B; Ramappa, Arun; Landzberg, Michael J; Thornhill, Thomas SKnee
Major orthopaedic procedures that involve instrumentation of the medullary canal are well known to produce showers of embolic debris including fat, bone fragments, marrow constituents, and cement. A growing literature has identified paradoxic cerebral embolism as a rare but serious consequence of the passage of these emboli through an intracardiac right-to-left shunt to the cerebral arterial circulation. We report 2 cases of paradoxic cerebral embolism after cemented total knee arthroplasty and propose a novel treatment plan to prevent recurrent stroke during subsequent surgery. Copyright 2003, Elsevier Science (USA). All rights reserved.
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