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.
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Current Concepts Review

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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