ArticleJournal of clinical orthopaedics and trauma2021
Cement extrusion and radial nerve palsy during revision shoulder and elbow arthroplasty: Beware of the cortical breach.
Article in Journal of clinical orthopaedics and trauma, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- Periprosthetic humeral fractures after shoulder arthroplasty.EFORT open reviews · 2025Review
- Cement-within-cement technique in revision reverse total shoulder arthroplasty: complications, reoperations, and revision rates at 5-year mean follow-up.JSES reviews, reports, and techniques · 2025Article
- Cortical windows for implant and cement removal during revision total elbow arthroplasty.JSES international · 2024Article
- Implant selection for successful reverse total shoulder arthroplasty.Clinics in shoulder and elbow · 2023Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Iatrogenic nerve injuries can cause patients and surgeons a great deal of distress and anxiety. To help prevent such injuries, surgeons should remain mindful for potential distortion of anatomy due to scarring and adhesions. Peripheral nerves are vulnerable to thermal injury, as well as mechanical injury by laceration and traction. Revision arthroplasty may involve removal of the implant and cement mantle. During this removal process, breaches in cortical bone can occur, with resultant cement extrusion within the soft tissues. Screw holes left vacant following screw removal may also allow for cement leakage. Thermal energy is released during the exothermic polymerisation process of cement curing. As a result, this thermal energy can also lead to injury to neural tissue. In this article, we present three cases of radial nerve palsy associated with cement extrusion during revision arthroplasty, in order to highlight pitfalls and learning points in the management. In addition, we propose strategies to avoid such injuries. Surgeons are reminded to be vigilant for cortical breaches intraoperatively, and if recognised, steps should be taken to minimise the risk of nerve injury.
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