Antibiotic Bone Cement Cannot Reduce Deep Infection After Primary Total Knee Arthroplasty

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.