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
(2023) In Acta Orthopaedica 94. p.416-425- 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, Den-mark, 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... (More)
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, Den-mark, 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.
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- 2023
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- Acta Orthopaedica
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- 94
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- 10 pages
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- Taylor & Francis
- external identifiers
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- pmid:37565339
- scopus:85168082261
- ISSN
- 1745-3674
- DOI
- 10.2340/17453674.2023.17737
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- English
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@article{bd4a6147-dacc-4702-9b95-6301c901b39c,
abstract = {{<p>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, Den-mark, 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.</p>}},
author = {{Leta, Tesfaye H. and Fenstad, Anne Marie and Lygre, Stein Håkon L. and Lie, Stein Atle and Lindberg-Larsen, Martin and Pedersen, Alma B. and W-Dahl, Annette and Rolfson, Ola and Bülow, Erik and Ashforth, James A. and VAN STEENBERGEN, Liza N. and Nelissen, Rob G.H.H. and Harries, Dylan and DE STEIGER, Richard and Lutro, Olav and Hakulinen, Emmi and Mäkelä, Keijo and Willis, Jinny and Wyatt, Michael and Frampton, Chris and Grimberg, Alexander and Steinbrück, Arnd and Wu, Yinan and Armaroli, Cristiana and Molinari, Marco and Picus, Roberto and Mullen, Kyle and Illgen, Richard and Stoica, Ioan C. and Vorovenci, Andreea E. and Dragomirescu, Dan and Dale, Håvard and Brand, Christian and Christen, Bernhard and Shapiro, Joanne and Wilkinson, J. Mark and Armstrong, Richard and Wooster, Kate and Hallan, Geir and Gjertsen, Jan Erik and Chang, Richard N. and Prentice, Heather A. and Paxton, Elizabeth W and Furnes, Ove}},
issn = {{1745-3674}},
language = {{eng}},
pages = {{416--425}},
publisher = {{Taylor & Francis}},
series = {{Acta Orthopaedica}},
title = {{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}},
url = {{http://dx.doi.org/10.2340/17453674.2023.17737}},
doi = {{10.2340/17453674.2023.17737}},
volume = {{94}},
year = {{2023}},
}