Related Experiment Video
Updated: May 4, 2026
A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
Published on: March 3, 2023
Routine use of antibiotic laden bone cement for primary total knee arthroplasty: impact on infecting microbial
Erik N Hansen1, Bahar Adeli1, Robert Kenyon1
1The Rothman Institute of Orthopaedics at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Abstract:
Antibiotic-laden bone cement (ALBC) is used in primary arthroplasties throughout Europe. In North America, ALBC is only FDA approved for revision arthroplasty after periprosthetic joint infection (PJI). No article has evaluated whether infecting microbial profile and resistance has changed with the introduction of ALBC. We hypothesized that prophylactic use of ALBC in primary total knee arthroplasty (TKA) has not had a significant impact on infecting pathogens, and antibiotic resistance profiles. A retrospective cohort analysis was conducted of all PJI patients undergoing primary TKA and total hip arthroplasty (THA) between January 2000 and January 2009. No significant change in the patterns of infecting PJI pathogens, and no notable increase in percentage resistance was found among organisms grown from patients with PJI that had received prophylactic antibiotic-loaded cement in their primary joint arthroplasty. Early findings suggest that routine prophylactic use of ALBC has not led to changes in infecting pathogen profile, nor has led to the emergence of antimicrobial resistance at our institution.
Insights
Prophylactic use of antibiotic-laden bone cement (ALBC) in primary joint replacements did not significantly alter infecting microbes or antibiotic resistance patterns. This study found no evidence of emerging resistance linked to ALBC use in arthroplasty.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Pharmacology
Background:
- Antibiotic-laden bone cement (ALBC) is widely used in primary arthroplasty in Europe but restricted to revision surgery in North America.
- The impact of prophylactic ALBC use on microbial profiles and antibiotic resistance in periprosthetic joint infection (PJI) remains unevaluated.
Purpose of the Study:
- To investigate whether the prophylactic use of ALBC in primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) has influenced the infecting microbial profile and antibiotic resistance patterns.
- To test the hypothesis that prophylactic ALBC does not significantly impact pathogens or resistance in PJI.
Main Methods:
- Retrospective cohort analysis of PJI patients undergoing primary TKA and THA between January 2000 and January 2009.
- Evaluation of microbial pathogens and their antibiotic resistance profiles in patients who received prophylactic ALBC during their primary joint arthroplasty.
Main Results:
- No significant changes were observed in the patterns of infecting pathogens causing PJI.
- No notable increase in the percentage of antibiotic resistance was found among organisms isolated from PJI patients who received prophylactic ALBC.
Conclusions:
- Routine prophylactic use of ALBC in primary joint arthroplasty has not led to significant changes in the infecting pathogen profile at the studied institution.
- The emergence of antimicrobial resistance has not been observed as a consequence of prophylactic ALBC use in primary TKA and THA.
More Related Videos
Related Concept Videos
01:25Clinical Significance of Antibiotic Resistance
01:25Mechanism of Antibiotic Resistance in MRSA