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

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention
• Biomaterials Science

Background:

• Deep infection is a severe complication after total knee arthroplasty (TKA).
• Antibiotic-loaded bone cement is used to prevent infections, but its efficacy in primary TKA is debated.

Purpose of the Study:

• To evaluate the prophylactic effect of antibiotic-loaded bone cement versus plain cement in preventing deep infections after primary total knee arthroplasty.

Main Methods:

• Retrospective review of 2293 primary TKA patients with 1-year follow-up.
• Collected data on risk factors including patient demographics, diagnosis, operative details, and cement type.
• Compared deep infection rates between antibiotic-loaded and plain cement groups using Fisher's exact test and logistic analysis.

Main Results:

• Deep infection rates were 0.40% for both antibiotic-loaded and plain cement groups (P=1.000).
• Logistic analysis, adjusted for risk factors, showed no significant reduction in deep infection rates with antibiotic-loaded bone cement (P=.865; OR, 0.835).

Conclusions:

• Antibiotic-loaded bone cement demonstrated no significant effect in preventing deep infections following primary total knee arthroplasty compared to plain cement.
• Further research may be needed to explore alternative prophylactic strategies for TKA infections.