Risk stratified usage of antibiotic-loaded bone cement for primary total knee arthroplasty: short term infection outcomes with a standardized cement protocol

J Arthroplasty. 2014 Aug;29(8):1622-4. doi: 10.1016/j.arth.2014.02.032. Epub 2014 Mar 5.


Efficacy of antibiotic cement (ALBC) in primary knee arthroplasty (pTKA) has been debated. The study's purpose was to examine efficacy of ALBC versus plain cement (PBC) in preventing infection in high-risk patients undergoing pTKA. 3292 consecutive pTKAs were divided into three cohorts: (1) patients receiving only PBC, (2) patients receiving only ALBC, and (3) only high-risk patients receiving ALBC. Cohorts' infections were compared. The 30-day infection rates for cohorts 1, 2, 3 were 0.29%, 0.20%, and 0.13% respectively. 6-month rates were 0.39%, 0.54% and 0.38%. 1-year rates were 0.78%, 0.61%, and 0.64%. Differences in infection rates at all time intervals were not statistically significant. The study supports that even judicious risk-stratified usage of ALBC may not confer added benefit in decreasing infection at one year.

Keywords: antibiotic cement; high-risk; primary knee arthroplasty.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Arthroplasty, Replacement, Knee / methods*
  • Arthroplasty, Replacement, Knee / statistics & numerical data
  • Bone Cements / therapeutic use*
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prosthesis-Related Infections / drug therapy*
  • Prosthesis-Related Infections / epidemiology
  • Prosthesis-Related Infections / prevention & control*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Bone Cements