Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection
Purpose: Antibiotic-loaded bone cement (ALBC) was usually used to prevent periprosthetic joint infection (PJI) in primary total knee arthroplasty (PTKA), but whether to use ALBC or plain bone cement in PTKA remains unclear. We aimed to compare the occurrence rate of PJI using two different cements,...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-11-01
|
| Series: | Chinese Journal of Traumatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S100812752200061X |
| _version_ | 1798018870854811648 |
|---|---|
| author | Ting Xu Ke-Liang Wu Ke Jie |
| author_facet | Ting Xu Ke-Liang Wu Ke Jie |
| author_sort | Ting Xu |
| collection | DOAJ |
| description | Purpose: Antibiotic-loaded bone cement (ALBC) was usually used to prevent periprosthetic joint infection (PJI) in primary total knee arthroplasty (PTKA), but whether to use ALBC or plain bone cement in PTKA remains unclear. We aimed to compare the occurrence rate of PJI using two different cements, and to investigate the efficacy of different antibiotic types and doses administered in preventing surgical site infection (SSI) with ALBC. Methods: The availability of ALBC for preventing PJI was evaluated by using a systematic review and meta-analysis referring to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Existing articles until December 2021 involving PTKA patients with both ALBC and plain bone cement cohorts were scanned by searching “total knee arthroplasty”, “antibiotic-loaded cement”, “antibiotic prophylaxis”, “antibiotic-impregnated cement” and “antibiotic-laden cement” in the database of PubMed/MEDLINE, Embase, Web of Science and the Cochrane Library. Subgroup analysis included the effectiveness of different antibiotic types and doses in preventing SSI with ALBC. The modified Jadad scale was employed to score the qualities of included articles. Results: Eleven quantitative studies were enrolled, including 34,159 knees undergoing PTKA. The meta-analysis results demonstrated that the use of prophylactic ALBC could significantly reduce the prevalence of deep incisional SSI after PTKA, whereas there was no significant reduction in the rate of superficial incisional SSI. Moreover, gentamicin-loaded cement was effective in preventing deep incisional SSI, and the use of high-dose ALBC significantly reduced the rate of deep incisional SSI after PTKA. Besides, no significant adverse reactions and complications were stated during the use of ALBC in PTKA. Conclusion: The preventive application of ALBC during PTKA could reduce the rates of deep PJI. Furthermore, bone cement containing gentamicin and high-dose ALBC could even better prevent deep infection after PTKA. However, the existing related articles are mostly single-center and retrospective studies, and further high-quality ones are needed for confirmation. |
| first_indexed | 2024-04-11T16:31:19Z |
| format | Article |
| id | doaj.art-58d17155556e4085b33b7259b5980db9 |
| institution | Directory Open Access Journal |
| issn | 1008-1275 |
| language | English |
| last_indexed | 2024-04-11T16:31:19Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Chinese Journal of Traumatology |
| spelling | doaj.art-58d17155556e4085b33b7259b5980db92022-12-22T04:14:00ZengElsevierChinese Journal of Traumatology1008-12752022-11-01256325330Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infectionTing Xu0Ke-Liang Wu1Ke Jie2Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, Guangdong Province, ChinaShenzhen Traditional Chinese Medicine Hospital, Shenzhen, 518000, Guangdong Province, ChinaFoshan Hospital of Traditional Chinese Medicine, Foshan, 528000, Guangdong Province, China; Corresponding author.Purpose: Antibiotic-loaded bone cement (ALBC) was usually used to prevent periprosthetic joint infection (PJI) in primary total knee arthroplasty (PTKA), but whether to use ALBC or plain bone cement in PTKA remains unclear. We aimed to compare the occurrence rate of PJI using two different cements, and to investigate the efficacy of different antibiotic types and doses administered in preventing surgical site infection (SSI) with ALBC. Methods: The availability of ALBC for preventing PJI was evaluated by using a systematic review and meta-analysis referring to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Existing articles until December 2021 involving PTKA patients with both ALBC and plain bone cement cohorts were scanned by searching “total knee arthroplasty”, “antibiotic-loaded cement”, “antibiotic prophylaxis”, “antibiotic-impregnated cement” and “antibiotic-laden cement” in the database of PubMed/MEDLINE, Embase, Web of Science and the Cochrane Library. Subgroup analysis included the effectiveness of different antibiotic types and doses in preventing SSI with ALBC. The modified Jadad scale was employed to score the qualities of included articles. Results: Eleven quantitative studies were enrolled, including 34,159 knees undergoing PTKA. The meta-analysis results demonstrated that the use of prophylactic ALBC could significantly reduce the prevalence of deep incisional SSI after PTKA, whereas there was no significant reduction in the rate of superficial incisional SSI. Moreover, gentamicin-loaded cement was effective in preventing deep incisional SSI, and the use of high-dose ALBC significantly reduced the rate of deep incisional SSI after PTKA. Besides, no significant adverse reactions and complications were stated during the use of ALBC in PTKA. Conclusion: The preventive application of ALBC during PTKA could reduce the rates of deep PJI. Furthermore, bone cement containing gentamicin and high-dose ALBC could even better prevent deep infection after PTKA. However, the existing related articles are mostly single-center and retrospective studies, and further high-quality ones are needed for confirmation.http://www.sciencedirect.com/science/article/pii/S100812752200061XSurgical site infectionAntibiotic-loaded cementPlain bone cementPeriprosthetic joint infectionPrimary total knee arthroplastyMeta |
| spellingShingle | Ting Xu Ke-Liang Wu Ke Jie Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection Chinese Journal of Traumatology Surgical site infection Antibiotic-loaded cement Plain bone cement Periprosthetic joint infection Primary total knee arthroplasty Meta |
| title | Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection |
| title_full | Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection |
| title_fullStr | Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection |
| title_full_unstemmed | Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection |
| title_short | Comprehensive meta-analysis of antibiotic-impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection |
| title_sort | comprehensive meta analysis of antibiotic impregnated bone cement versus plain bone cement in primary total knee arthroplasty for preventing periprosthetic joint infection |
| topic | Surgical site infection Antibiotic-loaded cement Plain bone cement Periprosthetic joint infection Primary total knee arthroplasty Meta |
| url | http://www.sciencedirect.com/science/article/pii/S100812752200061X |
| work_keys_str_mv | AT tingxu comprehensivemetaanalysisofantibioticimpregnatedbonecementversusplainbonecementinprimarytotalkneearthroplastyforpreventingperiprostheticjointinfection AT keliangwu comprehensivemetaanalysisofantibioticimpregnatedbonecementversusplainbonecementinprimarytotalkneearthroplastyforpreventingperiprostheticjointinfection AT kejie comprehensivemetaanalysisofantibioticimpregnatedbonecementversusplainbonecementinprimarytotalkneearthroplastyforpreventingperiprostheticjointinfection |