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  • Title: Paradoxic cerebral embolism after cemented knee arthroplasty: a report of 2 cases and prophylactic option for subsequent arthroplasty.
    Author: Yeon HB, Ramappa A, Landzberg MJ, Thornhill TS.
    Journal: J Arthroplasty; 2003 Jan; 18(1):113-20. PubMed ID: 12555195.
    Abstract:
    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.
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