Bone cement syndrome, usually an elderly hip problem, struck a 16-year-old

Bone cement implantation syndrome is typically associated with adult orthopedic surgery. This case report describes a 16-year-old boy (ASA II, BMI 31) who was undergoing reconstructive bone surgery using the Masquelet technique, in which a polymethylmethacrylate (PMMA) spacer is placed.

Shortly after the cement was applied, he developed sudden hypotension, a rapid heart rate and a drop in end-tidal CO₂, which the authors classified as Grade II syndrome. Fluids, ketamine and norepinephrine stabilized him during surgery. Afterward he had recurrent low blood pressure, acute kidney injury, and raised liver enzymes and creatine kinase. He recovered with intensive care and left the ICU on day five.

The authors describe the syndrome as exceptionally uncommon in pediatric patients. As a single case report, it cannot show how often this happens or what causes it in young patients.