Risk stratified usage of antibiotic-loaded bone cement for primary total knee arthroplasty: short term infection outcomes with a standardized cement protocol.
Efficacy of antibiotic cement (ALBC) in primary knee arthroplasty (pTKA) has been debated. The study's purpose was to examine efficacy of ALBC versus plain cement (PBC) in preventing infection in high-risk patients undergoing pTKA. 3292 consecutive pTKAs were divided into three cohorts: (1) patients receiving only PBC, (2) patients receiving only ALBC, and (3) only high-risk patients receiving ALBC. Cohorts' infections were compared. The 30-day infection rates for cohorts 1, 2, 3 were 0.29%, 0.20%, and 0.13% respectively. 6-month rates were 0.39%, 0.54% and 0.38%. 1-year rates were 0.78%, 0.61%, and 0.64%. Differences in infection rates at all time intervals were not statistically significant. The study supports that even judicious risk-stratified usage of ALBC may not confer added benefit in decreasing infection at one year.
Department of Orthopaedic Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana.
Rabah
R
Qadir
The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, Louisiana.
Sanbir
S
Sidhu
Department of Orthopaedic Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, Louisiana.
J Lockwood
JL
Ochsner
Department of Orthopaedic Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, Louisiana.
Mark S
MS
Meyer
Department of Orthopaedic Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, Louisiana.
George F
GF
Chimento
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods* / Q000706:statistics & numerical data; D001843:Bone Cements / Q000627:therapeutic use*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001843:Bone Cements
antibiotic cement; high-risk; primary knee arthroplasty