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Updated: Jan 27, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Staphylococcal resistance profiles in deep infection following primary hip and knee arthroplasty: a study using the
Richard J Holleyman1,2, David J Deehan3,4, Lucy Walker5
1Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK. r.holleyman@googlemail.com.
Introduction:
This study aimed to (1) report the rates of resistance against a variety of antibiotics for pure Staphylococcal infections, and (2) examine the impact of ALBC use at primary surgery has on resistance patterns for patients undergoing first-time revision of primary hip and knee arthroplasty for indication of infection.
Materials And Methods:
Data from the National Joint Registry database for England and Wales were linked to microbiology data held by Public Health England to identify a consecutive series of 258 primary hip and knee arthroplasties performed between April 2003 and January 2014 that went on to have a revision for Staphylococcal deep periprosthetic infection. Multivariate binary logistic regression was used to study predictors of microorganism resistance to a range of antimicrobials.
Results:
After adjusting for patient and surgical factors, multivariate analysis showed the use of gentamicin-loaded bone cement at the primary surgery was associated with a significant increase in the risk of Staphylococcal gentamicin resistance (odds ratio 8.341, 95% CI 2.297-30.292, p = 0.001) and methicillin resistance (odds ratio 3.870, 95% CI 1.319-11.359, p = 0.014) at revision for infection.
Conclusions:
Clinicians must anticipate the possibility of antibiotic resistance to ALBC utilised at primary surgery.
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