title: Antibiotic-loaded bone cement for infection prophylaxis in total joint replacement.
abstract: Use of antibiotic-loaded bone cement for prophylaxis against infection is not indicated for patients not at high risk for infection who are undergoing routine primary or revision joint replacement with cement. The mechanical and elution properties of commercially available premixed antibiotic-loaded bone-cement products are superior to those of hand-mixed preparations. Use of commercially available antibiotic-loaded bone-cement products has been cleared by the United States Food and Drug Administration only for use in the second stage of a two-stage total joint revision following removal of the original prosthesis and elimination of active periprosthetic infection. Use of antibiotic-loaded bone cement for prophylaxis against infection in the second stage of a two-stage total joint revision involves low doses of antibiotics. Active infection cannot be treated with commercially available antibiotic-loaded bone cement as such treatment requires higher doses of antibiotics.
authors.affiliation: Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, P.O. Box 980153, Richmond, VA 23298-0153, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Jiranek
authors.forename: Arlen D
authors.initials: AD
authors.lastname: Hanssen
authors.forename: A Seth
authors.initials: AS
authors.lastname: Greenwald
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D019643:Arthroplasty, Replacement; D001424:Bacterial Infections / Q000517:prevention & control; D001843:Bone Cements / Q000191:economics; D004342:Drug Hypersensitivity / Q000209:etiology; D004352:Drug Resistance, Microbial; D006801:Humans; D014677:Pharmaceutical Vehicles; D016459:Prosthesis-Related Infections / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D014677:Pharmaceutical Vehicles