Institutional members access full text with Ovid®

Share this article on:

Antibiotic-Impregnated Cement in Revision Total Knee Arthroplasty: A Prospective Cohort Study of One Hundred and Eighty-three Knees

Chiu, Fang-Yao MD; Lin, Chien-Fu Jeff MD, PhD

Journal of Bone & Joint Surgery - American Volume: 01 March 2009 - Volume 91 - Issue 3 - p 628–633
doi: 10.2106/JBJS.G.01570
Scientific Articles

Background: Deep infection following total knee arthroplasty is a devastating complication, and it is very important to prevent it. A prospective cohort study was conducted to evaluate the effect of vancomycin-impregnated cement on the prevention of deep infection after revision total knee arthroplasty performed in a setting in which so-called clean-air measures such as laminar flow and space suits were not available.

Methods: From 1993 to 2004, 183 first-time revision total knee arthroplasties were performed with fixation of all components with cement. The knees were divided randomly into two groups to evaluate the effect of vancomycin-impregnated cement in the prevention of postoperative infection. In Group 1 (ninety knees), the cement was not mixed with antibiotics; in Group 2 (ninety-three knees), vancomycin-impregnated cement was used for fixation. All of the patients were evaluated preoperatively and intraoperatively and found to be without infection at those times.

Results: At an average of eighty-nine months postoperatively, no deep infection had developed in the ninety-three knees in Group 2, whereas a deep infection had developed in six (7%) of the ninety knees in Group 1. This difference between Groups 1 and 2 was significant (p = 0.0130). One superficial wound infection developed in Group 1.

Conclusions: Vancomycin-impregnated cement was shown to be effective in the prevention of postoperative deep infection after revision total knee arthroplasty performed with antibiotic prophylaxis but not with so-called clean-air measures. This study provides preliminary evidence to justify larger trials.

Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.

1Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-pai Road, Taipei, Taiwan 11217, Republic of China. E-mail address for F.-Y. Chiu: fychiu@vghtpe.gov.tw

Copyright 2009 by The Journal of Bone and Joint Surgery, Incorporated
You currently do not have access to this article

To access this article: