Air embolism during total hip replacement: comparison of two surgical techniques.

The frequency of air embolism was studied in 21 patients during total hip replacement. Two groups were examined, one having femoral shaft cement insertion by hand, the other by Exeter cement gun. Venous air embolism was common throughout the hip surgery, but was especially so during prosthesis positioning in the femoral shaft. There were fewer air emboli and cardiovascular sequelae detected in the gun-inserted cement group, and the only patients to show clinically significant cardiovascular abnormalities during insertion of cement and prosthesis were those having cement insertion by hand. We conclude that the incidence of air embolism and associated cardiovascular changes during total hip replacement may be expected to be reduced in those patients in whom a cement gun is used to place the cement.