No Decreased Infection Rate When Using Antibiotic-Impregnated Cement in Primary Total Joint Arthroplasty

Educational Objectives As a result of reading this article, physicians should be able to: 1. Explain why periprosthetic infection is the most devastating complication of primary total joint arthroplasty. 2. Recognize the available strategies for using antibiotic-impregnated bone cement in patients undergoing primary total joint arthroplasty. 3. Discuss the potential strengths and limitations of using antibiotic-impregnated bone cement in primary total joint arthroplasty. 4. Recall the available evidence regarding the use of antibiotic-impregnated bone cement in primary total joint arthroplasty. There has been much debate and controversy about the routine use of antibiotic-impregnated bone cement in primary total joint arthroplasty. The purpose of this study was to undertake a meta-analysis to determine whether the use of antibiotic-impregnated bone cement would reduce the incidence of infection after primary total joint arthroplasty. Of 313 citations identified for screening, 6 trials reporting 26,791 patients were eligible for data extraction and meta-analysis. The authors found no statistically significant difference between antibiotic-impregnated bone cement and plain bone cement in terms of the incidence of infection. The results indicated that the use of antibiotic-impregnated bone cement in primary total joint arthroplasty did not lead to a decrease in the rate of infection. [ Orthopedics. 2014; 37(12):839–845.]