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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2015; 6(11): 877-885
Published online Dec 18, 2015. doi: 10.5312/wjo.v6.i11.877
Published online Dec 18, 2015. doi: 10.5312/wjo.v6.i11.877
Use of antibiotic-loaded cement in total knee arthroplasty
Pedro Hinarejos, Pau Guirro, Lluis Puig-Verdie, Raul Torres-Claramunt, Joan Leal-Blanquet, Juan Sanchez-Soler, Joan Carles Monllau, Department of Orthopedic Surgery, Hospital del Mar, Universitat Autònoma de Barcelona, 08024 Barcelona, Spain
Author contributions: Hinarejos P wrote the paper; Guirro P edited the paper; Puig-Verdie L, Torres-Claramunt R, Leal-Blanquet J, Sanchez-Soler J and Monllau JC searched for references, and assisted in the data collection and corrected the paper.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Pedro Hinarejos, MD, PhD, Department of Orthopedic Surgery, Hospital del Mar, Universitat Autònoma de Barcelona, Sant Josep de la Muntanya 12, 08024 Barcelona, Spain. phinarejos@parcdesalutmar.cat
Telephone: +34-93-3674255 Fax: +34-93-3674256
Received: May 27, 2015
Peer-review started: May 30, 2015
First decision: August 4, 2015
Revised: September 26, 2015
Accepted: October 16, 2015
Article in press: October 19, 2015
Published online: December 18, 2015
Peer-review started: May 30, 2015
First decision: August 4, 2015
Revised: September 26, 2015
Accepted: October 16, 2015
Article in press: October 19, 2015
Published online: December 18, 2015
Core Tip
Core tip: The bone cement capacity to release antibiotic molecules has been helpful in the treatment of prosthetic infections. Many authors have recommended the use of antibiotic loaded bone cement (ALBC) in total knee arthroplasty (TKA) for infection prophylaxis, but the actual evidence suggests a minimal, if any, protective effect against infection in TKA. There are some concerns against its routine use in primary TKA: The risk of toxicity, possible mechanical properties reduction, a significant increase in the cost of the cement, and the risk of selection of antibiotic-resistant bacteria. We recommend a cautious use of ALBC, perhaps only in high-risk patients, unless its benefits were better proven.