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Antibiotic-Loaded Bone Cement for Infection Prophylaxis in Total Joint Replacement

Jiranek, William A. MD; Hanssen, Arlen D. MD; Greenwald, A. Seth DPhil(Oxon)

Journal of Bone & Joint Surgery - American Volume: November 2006 - Volume 88 - Issue 11 - p 2487–2500
doi: 10.2106/JBJS.E.01126
Current Concepts Review
Supplementary Content

Use of antibiotic-loaded bone cement for prophylaxis against infection is not indicated for patients not at high risk for infection who are undergoing routine primary or revision joint replacement with cement.

The mechanical and elution properties of commercially available premixed antibiotic-loaded bone-cement products are superior to those of hand-mixed preparations.

Use of commercially available antibiotic-loaded bone-cement products has been cleared by the United States Food and Drug Administration only for use in the second stage of a two-stage total joint revision following removal of the original prosthesis and elimination of active periprosthetic infection.

Use of antibiotic-loaded bone cement for prophylaxis against infection in the second stage of a two-stage total joint revision involves low doses of antibiotics.

Active infection cannot be treated with commercially available antibiotic-loaded bone cement as such treatment requires higher doses of antibiotics.

1 Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, P.O. Box 980153, Richmond, VA 23298-0153

2 Department of Orthopedics, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905

3 Orthopaedic Research Laboratories, Lutheran Hospital, Cleveland Clinic Health System, 1730 West 25th Street, Cleveland, OH 44113. E-mail address: seth@orl-inc.com

Copyright 2006 by The Journal of Bone and Joint Surgery, Incorporated
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