The use of antibiotic-loaded bone cement and systemic antibiotic prophylactic use in 2,971,357 primary total knee arthroplasties from 2010 to 2020: an international register-based observational study among countries in Africa, Europe, North America, and Oceania
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Published:2023-08-09
Issue:
Volume:94
Page:416-425
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ISSN:1745-3682
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Container-title:Acta Orthopaedica
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language:
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Short-container-title:ActaO
Author:
Leta Tesfaye H, Fenstad Anne MarieORCID, Lygre Stein Håkon L, Lie Stein Atle, Lindberg-Larsen MartinORCID, Pedersen Alma BORCID, W-Dahl AnnetteORCID, Rolfson OlaORCID, Bülow ErikORCID, Ashforth James A, Van Steenbergen Liza NORCID, Nelissen Rob G H HORCID, Harries Dylan, De Steiger RichardORCID, Lutro OlavORCID, Hakulinen Emmi, Mäkelä Keijo, Willis Jinny, Wyatt MichaelORCID, Frampton Chris, Grimberg AlexanderORCID, Steinbrück Arnd, Wu Yinan, Armaroli Cristiana, Molinari Marco, Picus Roberto, Mullen Kyle, Illgen Richard, Stoica Ioan C, Vorovenci Andreea E, Dragomirescu Dan, Dale Håvard, Brand Christian, Christen Bernhard, Shapiro Joanne, Wilkinson J Mark, Armstrong Richard, Wooster Kate, Hallan Geir, Gjertsen Jan-ErikORCID, Chang Richard N, Prentice Heather AORCID, Paxton Elizabeth W, Furnes OveORCID
Abstract
Background and purpose: Antibiotic-loaded bone cement (ALBC) and systemic antibiotic prophylaxis (SAP) have been used to reduce periprosthetic joint infection (PJI) rates. We investigated the use of ALBC and SAP in primary total knee arthroplasty (TKA).Patients and methods: This observational study is based on 2,971,357 primary TKAs reported in 2010–2020 to national/regional joint arthroplasty registries in Australia, Denmark, Finland, Germany, Italy, the Netherlands, New Zealand, Norway, Romania, South Africa, Sweden, Switzerland, the UK, and the USA. Aggregate-level data on trends and types of bone cement, antibiotic agents, and doses and duration of SAP used was extracted from participating registries.Results: ALBC was used in 77% of the TKAs with variation ranging from 100% in Norway to 31% in the USA. Palacos R+G was the most common (62%) ALBC type used. The primary antibiotic used in ALBC was gentamicin (94%). Use of ALBC in combination with SAP was common practice (77%). Cefazolin was the most common (32%) SAP agent. The doses and duration of SAP used varied from one single preoperative dosage as standard practice in Bolzano, Italy (98%) to 1-day 4 doses in Norway (83% of the 40,709 TKAs reported to the Norwegian arthroplasty register).Conclusion: The proportion of ALBC usage in primary TKA varies internationally, with gentamicin being the most common antibiotic. ALBC in combination with SAP was common practice, with cefazolin the most common SAP agent. The type of ALBC and type, dose, and duration of SAP varied among participating countries.
Publisher
Medical Journals Sweden AB
Subject
Orthopedics and Sports Medicine,General Medicine,Surgery
Reference25 articles.
1. Randelli P, Evola F R, Cabitza P, Polli L, Denti M, Vaienti L. Prophylactic use of antibiotic-loaded bone cement in primary total knee replacement. Knee Surg Sports Traumatol Arthrosc 2010; 18: 181-6. doi: 10.1007/s00167-009-0921-y. 2. Shepard J, Ward W, Milstone A, Carlson T, Frederick J, Hadhazy E, et al. Financial impact of surgical site infections on hospitals: the hospital management perspective. JAMA Surg 2013; 148: 907-14. doi: 10.1001/jamasurg.2013.2246. 3. Dyrhovden G S, Lygre S H L, Badawy M, Gothesen O, Furnes O. Have the causes of revision for total and unicompartmental knee arthroplasties changed during the past two decades? Clin Orthop Relat Res 2017; 475: 1874-86. doi: 10.1007/s11999-017-5316-7. 4. Bozzo A, Ekhtiari S, Madden K, Bhandari M, Ghert M, Khanna V, et al. Incidence and predictors of prosthetic joint infection following primary total knee arthroplasty: a 15-year population-based cohort study. J Arthroplasty 2022; 37: 367-72.e361. doi: 10.1016/j.arth.2021.10.006. 5. Buchholz H, Elson R, Engelbrecht E, Lodenkamper H, Rottger J, Siegel A. Management of deep infection of total hip replacement. J Bone Joint Surg Br 1981; 63: 342-53. doi: 10.1302/0301-620X.63B3.7021561.
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