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Antibiotic-loaded Bone Cement as Prophylaxis in Total Joint Replacement.

Javier Martínez-Moreno1,2, Virginia Merino1, Amparo Nácher1

  • 1Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, Institute of Molecular Recognition and Technological Development, Mixed Center Polytechnic University of Valencia, University of Valencia, Valencia, Spain.

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Antibiotic-loaded bone cement effectively treats joint infections and offers high local antibiotic concentrations. However, its use for infection prevention in arthroplasty remains controversial due to concerns about resistance and effectiveness.

Keywords:
AntibioticArthroplastyBioactivityBone cementElution kinetics

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Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Biomaterials

Background:

  • Arthroplasty infections are serious complications, potentially leading to mortality.
  • Preventing infections during arthroplasty is a significant surgical challenge.

Purpose of the Study:

  • To review the evidence on antibiotic-loaded bone cements for arthroplasty infection prevention.
  • To discuss effectiveness, safety, antibiotic choice, cement properties, and release kinetics.

Main Methods:

  • Literature review of studies on antibiotic-loaded bone cements.
  • Analysis of effectiveness, safety, and potential complications like antibiotic resistance.
  • Evaluation of factors influencing antibiotic release and cement properties.

Main Results:

  • Antibiotic-loaded cements achieve high local antibiotic concentrations, beneficial for infection treatment.
  • Controversy exists regarding their role in infection prevention due to concerns about resistance, cost, and mechanical properties.

Conclusions:

  • Antibiotic-loaded bone cements are established for infection treatment.
  • Further evidence is needed to clarify their role and optimize their use for infection prevention in arthroplasty.