Total hip arthroplasty is associated with cardiopulmonary complications including cardiac arrest. We present one of four cases of cardiac arrest, two of the cases were fatal. The pathogenesis suggested to explain these complications is venous air embolism, generated by the methylmethacrylate bone cement polymerization causing thermal blood damage. To prevent this happening cortical bone allotransplantation around the prosthesis and bone cement with a low temperature of polymerization may be used.