Use of antibiotic-impregnated cement in total joint arthroplasty.
The use of antibiotic-impregnated cement in revision of total hip arthroplasty procedures is widespread, and a substantial body of evidence demonstrates its efficacy in infection prevention and treatment. However, it is not clear that it is necessary or desirable as a routine means of prophylaxis in primary total joint arthroplasty. In the management of infected implant sites, antibiotic-impregnated cement used in one-stage exchange arthroplasties has lowered reinfection rates. In two-stage procedures, use of beads and either articulating or nonarticulating antibiotic-impregnated cement spacers also has lowered reinfection rates. In addition, spacers reduce "dead space," help stabilize the limb, and facilitate reimplantation. Problems associated with antibiotic-impregnated cement in total joint arthroplasty include weakening of the cement and the generation of antibiotic-resistant bacteria in infected implant sites.
Joseph
Thomas N
TN
Department of Orthopaedic Surgery, Musculoskeletal Research Center, NYU-Hospital for Joint Diseases, New York, NY, USA.
Chen
Andrew L
AL
Di Cesare
Paul E
PE
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019643:Arthroplasty, Replacement; D001843:Bone Cements; D006801:Humans; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000517:prevention & control; D012086:Reoperation
D000900:Anti-Bacterial Agents; D001843:Bone Cements