Is the use of antibiotic-loaded bone cement associated with a lower risk of revision after primary total hip arthroplasty? a study of 418,857 total hip arthroplasties in the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man

Justin W. Leong, Michael J. Cook, Terence W. O’neill, Timothy N. Board

Research output: Contribution to journalArticlepeer-review

48 Downloads (Pure)

Abstract

Aims The aim of this study was to investigate whether the use of antibiotic-loaded bone cement influenced the risk of revision surgery after primary total hip arthroplasty (THA) for osteoarthritis. Methods The study involved data collected by the National Joint Registry (NJR) for England and Wales, Northern Ireland and the Isle of Man between 1 September 2005 and 31 August 2017. Cox proportional hazards were used to investigate the association between use of antibiotic-loaded bone cement and the risk of revision due to prosthetic joint infection (PJI), with adjustments made for the year of the initial procedure, age at the time of surgery, sex, American Society of Anesthesiologists (ASA) grade, head size, and body mass index (BMI). We looked also at the association between use of antibiotic-loaded bone cement and the risk of revision due to aseptic loosening or osteolysis. Results The cohort included 418,857 THAs of whom 397,896 had received antibiotic-loaded bone cement and 20,961 plain cement. After adjusting for putative confounding factors, the risk of revision for PJI was lower in those in whom antibiotic-loaded bone cement was used (hazard ration (HR) 0.79; 95% confidence interval (CI) 0.64 to 0.98). There was also a protective effect on the risk of revision due to aseptic loosening or osteolysis, in the period of > 4.1 years after primary THA, HR 0.57, 95% CI 0.45, 0.72. Conclusion Within the limits of registry analysis, this study showed an association between the use of antibiotic-loaded bone cement and lower rates of revision due to PJI. The findings support the continued use of antibiotic-loaded bone cement in cemented THA.
Original languageEnglish
Pages (from-to)997-1002
Number of pages6
JournalThe Bone & Joint Journal
Volume102-B
Issue number8
Early online date31 Jul 2020
DOIs
Publication statusE-pub ahead of print - 31 Jul 2020

Keywords

  • Antibiotics loaded bone cement
  • Infection
  • Plain cement
  • Revision
  • Total Hip Arthroplasty

Fingerprint

Dive into the research topics of 'Is the use of antibiotic-loaded bone cement associated with a lower risk of revision after primary total hip arthroplasty? a study of 418,857 total hip arthroplasties in the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man'. Together they form a unique fingerprint.

Cite this