Outcomes of routine use of antibiotic-loaded cement in primary total knee arthroplasty.
The routine use of antibiotic-loaded bone cement (ALBC) in primary total knee arthroplasty (TKA) is controversial. Outcomes were recorded in patients who underwent primary TKA from May 2003 to March 2007 using a community-based total joint registry. Infection rates were compared in patients undergoing TKA with ALBC and regular cement. A total of 22 889 primary TKA were performed, with 2030 cases (8.9%) using ALBC. Two thousand four hundred forty-nine patients were diabetic (10.7%), with ALBC used in 295 cases (12%). The rate of deep infection was 1.4% for ALBC TKA (28 cases) and 0.7% (154 cases) with regular cement (P = .002). Among patients with diabetes, the infection rate was 1.7% (5 cases) with ALBC and 0.9% (19 cases) with regular cement (P = .199). In patients whom surgeons considered higher risk for infection, ALBC did not appear to reduce TKA infection rates. The routine use of antibiotic-laden cement warrants further investigation.
Namba
Robert S
RS
Department of Orthopedics, Kaiser Permanente, USA.
Chen
Yuexin
Y
Paxton
Elizabeth W
EW
Slipchenko
Tamara
T
Fithian
Donald C
DC
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001843:Bone Cements; D015331:Cohort Studies; D016503:Drug Delivery Systems / Q000379:methods*; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D015233:Models, Statistical; D015999:Multivariate Analysis; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D012042:Registries; D012189:Retrospective Studies; D015983:Selection Bias; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001843:Bone Cements