Published online Dec 18, 2015. doi: 10.5312/wjo.v6.i11.877
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: 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.