title: Antibiotic Bone Cement Cannot Reduce Deep Infection After Primary Total Knee Arthroplasty.
abstract: Deep infection following total knee arthroplasty is a catastrophic complication. Recently, antibiotic-loaded bone cement has been applied to prevent deep infection after total joint arthroplasty. However, there is still controversy about the prophylactic effect of antibiotic-loaded bone cement after primary total knee arthroplasty. This study reviewed 2293 patients who underwent primary total knee arthroplasty with 1-year follow-up at the authors' hospital between February 2003 and October 2012 (mean±SD age, 64.8±10.7 years; male-to-female ratio, 1:5). All potential risk factors, including sex, age, height, weight, body mass index, diagnosis (osteoarthritis or other), diabetic status, operative time (categorized as either ≤120 minutes or >120 minutes), bilateral/unilateral procedure, surgeon volume (categorized as either ≥30 cases/year or <30 cases/year), and bone cement type, were collected. A total of 10 patients who had deep infection were identified during follow-up. Rates of deep infection for antibiotic-loaded bone cement and for plain cement were both 0.40%, and the difference was not significant with Fisher's exact test (P=1.000). Adjusted for the unevenly distributed risk factors (age, height, weight, diagnosis, bilateral/unilateral surgery, and operative time) in both groups, the results of logistic analysis showed that antibiotic-loaded bone cement did not reduce the rate of deep infection following primary total knee arthroplasty compared with plain cement (P=.865; odds ratio, 0.835; 95% confidence interval, 0.105-6.713). The study showed that antibiotic-loaded bone cement had no effect on the prevention of deep infection after primary total knee arthroplasty.
authors.forename: Hai
authors.initials: H
authors.lastname: Wang
authors.forename: Gui-Xing
authors.initials: GX
authors.lastname: Qiu
authors.forename: Jin
authors.initials: J
authors.lastname: Lin
authors.forename: Jin
authors.initials: J
authors.lastname: Jin
authors.forename: Wen-Wei
authors.initials: WW
authors.lastname: Qian
authors.forename: Xi-Sheng
authors.initials: XS
authors.lastname: Weng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods; D001843:Bone Cements; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements