The Journal of Bone and Joint Surgery (American). 2006;88:2487-2500.
doi:10.2106/JBJS.E.01126
© 2006 The Journal of Bone and Joint Surgery, Inc.
Antibiotic-Loaded Bone Cement for Infection Prophylaxis in Total Joint Replacement
William A. Jiranek, MD1,
Arlen D. Hanssen, MD2 and
A. Seth Greenwald, DPhil(Oxon)3
1 Department of Orthopaedic Surgery, Virginia Commonwealth University Health
System, P.O. Box 980153, Richmond, VA 23298-0153
2 Department of Orthopedics, Mayo Clinic, 200 First Street S.W., Rochester, MN
55905
3 Orthopaedic Research Laboratories, Lutheran Hospital, Cleveland Clinic Health
System, 1730 West 25th Street, Cleveland, OH 44113. E-mail address:
seth{at}orl-inc.com
NOTE: The authors thank Christine S. Heim, BSc, for her
contributions to this publication.
The authors did not receive grants or outside funding in support of their
research for or preparation of this manuscript. They did not receive payments
or other benefits or a commitment or agreement to provide such benefits from a
commercial entity. No commercial entity paid or directed, or agreed to pay or
direct, any benefits to any research fund, foundation, educational
institution, or other charitable or nonprofit organization with which the
authors are affiliated or associated.
Use of antibiotic-loaded bone cement for prophylaxis against infection is
not indicated for patients not at high risk for infection who are undergoing
routine primary or revision joint replacement with cement.
The mechanical and elution properties of commercially available premixed
antibiotic-loaded bone-cement products are superior to those of hand-mixed
preparations.
Use of commercially available antibiotic-loaded bone-cement products has
been cleared by the United States Food and Drug Administration only for use in
the second stage of a two-stage total joint revision following removal of the
original prosthesis and elimination of active periprosthetic infection.
Use of antibiotic-loaded bone cement for prophylaxis against infection in
the second stage of a two-stage total joint revision involves low doses of
antibiotics.
Active infection cannot be treated with commercially available
antibiotic-loaded bone cement as such treatment requires higher doses of
antibiotics.
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