Journal
JOURNAL OF ARTHROPLASTY
Volume 24, Issue 6, Pages 44-47Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2009.05.007
Keywords
antibiotic-loaded cement; infection rate; primary total knee arthroplasty
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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.
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