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Antibiotic-loaded acrylic cement: current concepts.

H W Buchholz, R A Elson, K Heinert

    Clinical Orthopaedics and Related Research
    |November 1, 1984
    PubMed
    Summary
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    Antibiotic-loaded acrylic cement shows a 77% success rate for infected total hip arthroplasties, with Pseudomonas infections posing a significant risk. This data aids in understanding treatment outcomes for joint replacements.

    Area of Science:

    • Orthopedic Surgery
    • Biomaterials Science
    • Infectious Disease

    Background:

    • Antibiotic-loaded acrylic cement has been a routine material in joint arthroplasty since 1972.
    • Over 22,000 joint arthroplasty operations were performed between 1964-1983 using this material.
    • Previous follow-up statistics on prophylactic therapy and deep infections have been published.

    Purpose of the Study:

    • To present the current status and updated follow-up statistics of antibiotic-loaded acrylic cement in joint arthroplasty.
    • To compare the results of 869 exchange arthroplasties with previously published data.
    • To introduce the use of survival curves for future analysis and comparison of treatment outcomes.

    Main Methods:

    • Retrospective actuarial analysis of 825 one-stage reimplantations for infected total hip arthroplasties.

    Related Experiment Videos

  • Utilized antibiotic-loaded acrylic cement in all cases.
  • Statistical comparison of failure rates for different microorganisms, including Staphylococcus aureus, S. species, and Pseudomonas.

    • Main Results:

    • Staphylococcus aureus was the most frequently identified organism in infected prostheses.
    • Failure rates for prostheses infected by S. aureus, S. species, and anaerobic corynebacteria were not statistically different.
    • Pseudomonas infection was identified as a significant factor contributing to treatment failure.

    Conclusions:

    • The study calculated a 77% success (survival) rate five years after operation for infected total hip arthroplasties treated with antibiotic-loaded acrylic cement.
    • Survival curves are recommended for ease of comparison and analysis of covariable factors in future studies.
    • While effective, Pseudomonas infections present a challenge to the success of this treatment method.