The Use of Erythromycin and Colistin Cement in Total Knee Arthroplasty Does Not Reduce the Incidence of Infection

Background: One of the most severe complications of primary total knee arthroplasty (TKA) is prosthetic joint infection. Currently, the use of antibiotic-loaded cement for the prevention of infection is still controversial. The aim of the present study was to evaluate if the use of antibiotic-loaded...

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Autores: Pardo-Pol, Albert|||0000-0003-0781-072X, Fontanellas Fes, Albert|||0000-0002-4628-9466, Pérez-Prieto, Daniel|||0000-0002-7112-0742, Sorlí, Luisa|||0000-0001-9562-514X, Hinarejos Gómez, Pedro|||0000-0001-7567-1317, Monllau García, Joan Carles|||0000-0002-2418-4874
Formato: artículo
Fecha de publicación:2024
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:311951
Acesso em linha:https://ddd.uab.cat/record/311951
https://dx.doi.org/urn:doi:10.1016/j.arth.2024.04.039
Access Level:acceso embargado
Palavra-chave:Total knee arthroplasty
Antibiotic-loaded bone cement
Periprosthetic joint infection
Antibiotic resistance
Aseptic loosening
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spelling The Use of Erythromycin and Colistin Cement in Total Knee Arthroplasty Does Not Reduce the Incidence of InfectionA Randomized Study in 2,893 Knees With a 9-year Average Follow-UpPardo-Pol, Albert|||0000-0003-0781-072XFontanellas Fes, Albert|||0000-0002-4628-9466Pérez-Prieto, Daniel|||0000-0002-7112-0742Sorlí, Luisa|||0000-0001-9562-514XHinarejos Gómez, Pedro|||0000-0001-7567-1317Monllau García, Joan Carles|||0000-0002-2418-4874Total knee arthroplastyAntibiotic-loaded bone cementPeriprosthetic joint infectionAntibiotic resistanceAseptic looseningBackground: One of the most severe complications of primary total knee arthroplasty (TKA) is prosthetic joint infection. Currently, the use of antibiotic-loaded cement for the prevention of infection is still controversial. The aim of the present study was to evaluate if the use of antibiotic-loaded cement reduces the infection rate in primary TKA in long-term follow-up (more than 5 years average follow-up). Methods: This study is the follow-up extension of a prospective randomized study, with 2,893 cemented TKA performed between 2005 and 2010 at our institution. There were 2 different cohorts depending on which bone cement was used: without antibiotics (control group) or those loaded with erythromycin and colistin (study group). All patients received the same systemic prophylactic antibiotics. The patients were followed for a minimum of twelve months. The diagnosis of prosthetic joint infection was done according to Zimmerli criteria. Results: In 1,452 patients, the prosthetic components were fixed using bone cement without antibiotics, whereas in 1,441 patients, bone cement was loaded with erythromycin and colistin. Both groups were comparable in terms of all the possible risk factors studied. We found a total of 53 deep infections, with a mean rate of 1.8%. There were no differences between the groups as to whether bone cement with or without antibiotics had been used (P =.58). The average duration of follow-up was 8.7 years. In terms of prosthetic revision due to aseptic loosening, there were no differences between groups (P =.32), with 33 revision arthroplasties in the control group and 37 in the study group. Moreover, we analyzed the erythromycin resistance rate, with no differences between both groups (P =.6). Conclusions: The use of erythromycin and colistin-loaded bone cement in TKA did not lead to a decrease in the rate of infection in long-term follow-up, a finding that suggests that its use would not be indicated in the general population. 22024-01-0120242024-01-01Articlehttp://purl.org/coar/resource_type/c_6501AMhttp://purl.org/coar/version/c_ab4af688f83e57aainfo:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/311951https://dx.doi.org/urn:doi:10.1016/j.arth.2024.04.039reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengembargoed accesshttp://purl.org/coar/access_right/c_f1cfAquest material està protegit per drets d'autor i/o drets afins. Podeu utilitzar aquest material en funció del que permet la legislació de drets d'autor i drets afins d'aplicació al vostre cas. Per a d'altres usos heu d'obtenir permís del(s) titular(s) de drets.https://rightsstatements.org/vocab/InC/1.0/info:eu-repo/semantics/embargoedAccessoai:ddd.uab.cat:3119512026-06-06T12:50:31Z
dc.title.none.fl_str_mv The Use of Erythromycin and Colistin Cement in Total Knee Arthroplasty Does Not Reduce the Incidence of Infection
A Randomized Study in 2,893 Knees With a 9-year Average Follow-Up
title The Use of Erythromycin and Colistin Cement in Total Knee Arthroplasty Does Not Reduce the Incidence of Infection
spellingShingle The Use of Erythromycin and Colistin Cement in Total Knee Arthroplasty Does Not Reduce the Incidence of Infection
Pardo-Pol, Albert|||0000-0003-0781-072X
Total knee arthroplasty
Antibiotic-loaded bone cement
Periprosthetic joint infection
Antibiotic resistance
Aseptic loosening
title_short The Use of Erythromycin and Colistin Cement in Total Knee Arthroplasty Does Not Reduce the Incidence of Infection
title_full The Use of Erythromycin and Colistin Cement in Total Knee Arthroplasty Does Not Reduce the Incidence of Infection
title_fullStr The Use of Erythromycin and Colistin Cement in Total Knee Arthroplasty Does Not Reduce the Incidence of Infection
title_full_unstemmed The Use of Erythromycin and Colistin Cement in Total Knee Arthroplasty Does Not Reduce the Incidence of Infection
title_sort The Use of Erythromycin and Colistin Cement in Total Knee Arthroplasty Does Not Reduce the Incidence of Infection
dc.creator.none.fl_str_mv Pardo-Pol, Albert|||0000-0003-0781-072X
Fontanellas Fes, Albert|||0000-0002-4628-9466
Pérez-Prieto, Daniel|||0000-0002-7112-0742
Sorlí, Luisa|||0000-0001-9562-514X
Hinarejos Gómez, Pedro|||0000-0001-7567-1317
Monllau García, Joan Carles|||0000-0002-2418-4874
author Pardo-Pol, Albert|||0000-0003-0781-072X
author_facet Pardo-Pol, Albert|||0000-0003-0781-072X
Fontanellas Fes, Albert|||0000-0002-4628-9466
Pérez-Prieto, Daniel|||0000-0002-7112-0742
Sorlí, Luisa|||0000-0001-9562-514X
Hinarejos Gómez, Pedro|||0000-0001-7567-1317
Monllau García, Joan Carles|||0000-0002-2418-4874
author_role author
author2 Fontanellas Fes, Albert|||0000-0002-4628-9466
Pérez-Prieto, Daniel|||0000-0002-7112-0742
Sorlí, Luisa|||0000-0001-9562-514X
Hinarejos Gómez, Pedro|||0000-0001-7567-1317
Monllau García, Joan Carles|||0000-0002-2418-4874
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Total knee arthroplasty
Antibiotic-loaded bone cement
Periprosthetic joint infection
Antibiotic resistance
Aseptic loosening
topic Total knee arthroplasty
Antibiotic-loaded bone cement
Periprosthetic joint infection
Antibiotic resistance
Aseptic loosening
description Background: One of the most severe complications of primary total knee arthroplasty (TKA) is prosthetic joint infection. Currently, the use of antibiotic-loaded cement for the prevention of infection is still controversial. The aim of the present study was to evaluate if the use of antibiotic-loaded cement reduces the infection rate in primary TKA in long-term follow-up (more than 5 years average follow-up). Methods: This study is the follow-up extension of a prospective randomized study, with 2,893 cemented TKA performed between 2005 and 2010 at our institution. There were 2 different cohorts depending on which bone cement was used: without antibiotics (control group) or those loaded with erythromycin and colistin (study group). All patients received the same systemic prophylactic antibiotics. The patients were followed for a minimum of twelve months. The diagnosis of prosthetic joint infection was done according to Zimmerli criteria. Results: In 1,452 patients, the prosthetic components were fixed using bone cement without antibiotics, whereas in 1,441 patients, bone cement was loaded with erythromycin and colistin. Both groups were comparable in terms of all the possible risk factors studied. We found a total of 53 deep infections, with a mean rate of 1.8%. There were no differences between the groups as to whether bone cement with or without antibiotics had been used (P =.58). The average duration of follow-up was 8.7 years. In terms of prosthetic revision due to aseptic loosening, there were no differences between groups (P =.32), with 33 revision arthroplasties in the control group and 37 in the study group. Moreover, we analyzed the erythromycin resistance rate, with no differences between both groups (P =.6). Conclusions: The use of erythromycin and colistin-loaded bone cement in TKA did not lead to a decrease in the rate of infection in long-term follow-up, a finding that suggests that its use would not be indicated in the general population.
publishDate 2024
dc.date.none.fl_str_mv 2
2024-01-01
2024
2024-01-01
dc.type.none.fl_str_mv Article
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dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/311951
https://dx.doi.org/urn:doi:10.1016/j.arth.2024.04.039
url https://ddd.uab.cat/record/311951
https://dx.doi.org/urn:doi:10.1016/j.arth.2024.04.039
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
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