Leta, Tesfaye H; Fenstad, Anne Marie; Lygre, Stein Håkon L; Lie, Stein Atle; Lindberg-Larsen, Martin; Pedersen, Alma B; W-Dahl, Annette; Rolfson, Ola; Bülow, Erik; Ashforth, James A; Van Steenbergen, Liza N; Nelissen, Rob G H H; Harries, Dylan; De Steiger, Richard; Lutro, Olav; Hakulinen, Emmi; Mäkelä, Keijo; Willis, Jinny; Wyatt, Michael; Frampton, Chris; ... (2023). 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. Acta orthopaedic, 94, pp. 416-425. Medical Journals Sweden AB 10.2340/17453674.2023.17737
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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, Denmark, 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.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM) |
UniBE Contributor: |
Brand, Christian Michael Georg |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
1745-3682 |
Publisher: |
Medical Journals Sweden AB |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
14 Aug 2023 13:02 |
Last Modified: |
17 Aug 2023 16:26 |
Publisher DOI: |
10.2340/17453674.2023.17737 |
PubMed ID: |
37565339 |
BORIS DOI: |
10.48350/185394 |
URI: |
https://boris.unibe.ch/id/eprint/185394 |
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