DOI: https://doi.org/10.36347/sjmcr.2026.v14i01.031

Pages: 131-133

Pulmonary cement embolism (PCE) is a rare but potentially life-threatening complication of orthopedic procedures involving bone cement, most commonly reported after vertebroplasty or kyphoplasty, with femoral surgeries being exceptionally uncommon. While most cases are asymptomatic or respond to anticoagulation, progression to pulmonary infarction requiring surgical intervention is exceedingly rare. We report a 53-year-old female patient who underwent femoral endoprosthesis surgery and was promptly diagnosed with acute PCE. However, surgical management was delayed as the patient remained indecisive for several days, during which the embolism progressed to pulmonary infarction, ultimately necessitating a left lower lobectomy. Cement emboli most frequently originate from the proximal femur or vertebrae, where intramedullary pressurization is highest, and symptomatic PCE occurs in approximately 0.1–1% of cemented orthopedic procedures. Cases requiring lobectomy are extremely rare, reported in fewer than 2% of symptomatic PCEs. Risk factors include high cement volume, pressurization technique, intramedullary hypertension, and pre-existing venous channels. This case highlights the critical importance of early recognition and timely intervention, as delays may result in infarction and the need for major surgical procedures. Awareness of PCE as a potential complication of femoral endoprosthesis surgery is essential for orthopedic and cardiothoracic teams to ensure prompt management and favorable patient outcomes.