Periprosthetic Joint Infection After Total Knee Arthroplasty With or Without Antibiotic Bone Cement

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Periprosthetic Joint Infection After Total Knee Arthroplasty With or Without Antibiotic Bone Cement

Leta, Tesfaye H. (author): Weill Cornell Medical College,Kaiser Permanente,Haukeland University Hospital

Lie, Stein Atle (author): University of Bergen,Haukeland University Hospital

Fenstad, Anne Marie (author): Haukeland University Hospital

Lygre, Stein Håkon L. (author): Haukeland University Hospital

Lindberg-Larsen, Martin (author): Odense University Hospital

Pedersen, Alma B. (author): Aarhus University Hospital

W-Dahl, Annette (author): Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,The Swedish Knee Arthroplasty Register

Rolfson, Ola (author): Sahlgrenska Academy

Bülow, Erik (author): Sahlgrenska Academy,The County of Västra Götaland

van Steenbergen, Liza N. (author)

Nelissen, Rob G.H.H. (author): Leiden University Medical Centre

Harries, Dylan (author): South Australian Health and Medical Research Institute

de Steiger, Richard (author)

Lutro, Olav (author): Stavanger University Hospital

Mäkelä, Keijo (author): Turku University Hospital

Venäläinen, Mikko S. (author): Turku University Hospital

Willis, Jinny (author)

Wyatt, Michael (author)

Frampton, Chris (author)

Grimberg, Alexander (author)

Steinbrück, Arnd (author)

Wu, Yinan (author)

Armaroli, Cristiana (author)

Gentilini, Maria Adalgisa (author)

Picus, Roberto (author)

Bonetti, Mirko (author)

Dragosloveanu, Serban (author): Carol Davila University of Medicine and Pharmacy

Vorovenci, Andreea E. (author)

Dragomirescu, Dan (author)

Dale, Håvard (author): Haukeland University Hospital

Brand, Christian (author): University of Bern

Christen, Bernhard (author)

Shapiro, Joanne (author)

Wilkinson, J. Mark (author): University of Sheffield

Armstrong, Richard (author)

Wooster, Kate (author)

Hallan, Geir (author): Haukeland University Hospital

Gjertsen, Jan Erik (author): Haukeland University Hospital

Chang, Richard N. (author): Kaiser Permanente

Prentice, Heather A. (author): Kaiser Permanente

Sedrakyan, Art (author): Weill Cornell Medical College

Paxton, Elizabeth W. (author): Kaiser Permanente

Furnes, Ove (author): Haukeland University Hospital

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(creator_code:org_t)

2024
2024
English.
In: JAMA Network Open. - 2574-3805. ; 7:5, s. 2412898-2412898

Related links:: http://dx.doi.org/10... (free); show more...; https://lup.lub.lu.s...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Importance: Despite increased use of antibiotic-loaded bone cement (ALBC) in joint arthroplasty over recent decades, current evidence for prophylactic use of ALBC to reduce risk of periprosthetic joint infection (PJI) is insufficient. Objective: To compare the rate of revision attributed to PJI following primary total knee arthroplasty (TKA) using ALBC vs plain bone cement. Design, Setting, and Participants: This international cohort study used data from 14 national or regional joint arthroplasty registries in Australia, Denmark, Finland, Germany, Italy, New Zealand, Norway, Romania, Sweden, Switzerland, the Netherlands, the UK, and the US. The study included primary TKAs for osteoarthritis registered from January 1, 2010, to December 31, 2020, and followed-up until December 31, 2021. Data analysis was performed from April to September 2023. Exposure: Primary TKA with ALBC vs plain bone cement. Main Outcomes and Measures: The primary outcome was risk of 1-year revision for PJI. Using a distributed data network analysis method, data were harmonized, and a cumulative revision rate was calculated (1 - Kaplan-Meier), and Cox regression analyses were performed within the 10 registries using both cement types. A meta-analysis was then performed to combine all aggregated data and evaluate the risk of 1-year revision for PJI and all causes. Results: Among 2 168 924 TKAs included, 93% were performed with ALBC. Most TKAs were performed in female patients (59.5%) and patients aged 65 to 74 years (39.9%), fully cemented (92.2%), and in the 2015 to 2020 period (62.5%). All participating registries reported a cumulative 1-year revision rate for PJI of less than 1% following primary TKA with ALBC (range, 0.21%-0.80%) and with plain bone cement (range, 0.23%-0.70%). The meta-analyses based on adjusted Cox regression for 1 917 190 TKAs showed no statistically significant difference at 1 year in risk of revision for PJI (hazard rate ratio, 1.16; 95% CI, 0.89-1.52) or for all causes (hazard rate ratio, 1.12; 95% CI, 0.89-1.40) among TKAs performed with ALBC vs plain bone cement. Conclusions and Relevance: In this study, the risk of revision for PJI was similar between ALBC and plain bone cement following primary TKA. Any additional costs of ALBC and its relative value in reducing revision risk should be considered in the context of the overall health care delivery system.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)

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By the author/editor: Leta, Tesfaye H.; Lie, Stein Atle; Fenstad, Anne Ma ...; Lygre, Stein Håk ...; Lindberg-Larsen, ...; Pedersen, Alma B ...; show more...; W-Dahl, Annette; Rolfson, Ola; Bülow, Erik; van Steenbergen, ...; Nelissen, Rob G. ...; Harries, Dylan; de Steiger, Rich ...; Lutro, Olav; Mäkelä, Keijo; Venäläinen, Mikk ...; Willis, Jinny; Wyatt, Michael; Frampton, Chris; Grimberg, Alexan ...; Steinbrück, Arnd; Wu, Yinan; Armaroli, Cristi ...; Gentilini, Maria ...; Picus, Roberto; Bonetti, Mirko; Dragosloveanu, S ...; Vorovenci, Andre ...; Dragomirescu, Da ...; Dale, Håvard; Brand, Christian; Christen, Bernha ...; Shapiro, Joanne; Wilkinson, J. Ma ...; Armstrong, Richa ...; Wooster, Kate; Hallan, Geir; Gjertsen, Jan Er ...; Chang, Richard N ...; Prentice, Heathe ...; Sedrakyan, Art; Paxton, Elizabet ...; Furnes, Ove; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Orthopaedics

Articles in the publication: JAMA Network Ope ...

By the university: Lund University

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