Antibiotic-loaded bone cement in total joint arthroplasty


Published online: Jun 27 2015

Daniel SOARES, Pedro LEITE, Pedro BARREIRA, Ricardo AIDO, Ricardo SOUSA

From Department of Orthopaedics, Centro Hospitalar do Porto – Hospital de Santo António, Porto, Portugal

Abstract

Periprosthetic joint infection is a devastating complication after total joint replacement. Prevention is mandatory and systemic antibiotic prophylaxis is nowadays a recognized cornerstone. Further addition of local antibiotics eluting from bone cement is a real possibility but its routine use is controversial. Pros and cons of its routine use in primary and revision total joint arthroplasty will be discussed. Cement spacers carrying high doses of antibiotic(s) are currently accepted during two-stage treatment of infected prosthetic joints. Several issues such as alternatives to classic antibiotics, optimal dosages and others will also be explored.