Comparable bone penetration between antibiotic-loaded and plain bone cement in total knee arthroplasty.
antibiotic‐loaded bone cement
bone cement penetration
prospective randomized study
radiological intrusion
total knee arthroplasty
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
21 Jul 2024
21 Jul 2024
Historique:
revised:
07
07
2024
received:
10
02
2024
accepted:
08
07
2024
medline:
21
7
2024
pubmed:
21
7
2024
entrez:
21
7
2024
Statut:
aheadofprint
Résumé
One of the main concerns around the use of antibiotic-loaded bone cement (ALBC) is the potential reduction in the mechanical properties of the cement when antibiotics are admixed. The purpose of this study was to determine whether there is a difference between plain cement and ALBC in terms of radiological intrusion into the bone in total knee arthroplasties (TKAs). Prospective randomized study of 80 consecutive patients who underwent TKA. Depending on the cement used, patients were divided into two groups by a computer-generated randomization programme: the cement without antibiotic (Group 1) or the ALBC (Group 2). Cement intrusion was measured in postoperative radiographs in eight different regions in the tibial component and six regions in the femoral component. The average cement intrusion was similar in both groups (p = nonsignificance [n.s.]). Group 1 (plain cement) had an average cement intrusion in the femur of 1.4 mm (±0.4) and 2.4 mm (±0.4) in the tibia. In Group 2 (ALBC), the average cement intrusion in the femur came to 1.6 (±0.5) and 2.4 mm (±0.5) in the tibia. In 80% of the patients, the cement intrusion in the tibia averaged a minimum of 2 mm, being similar in both groups (p = n.s.). There are no differences in bone intrusion when comparing plain cement to ALBC. Therefore, the use of ALBC in primary TKA may be indicated, achieving optimal bone penetration. Level I.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.
Références
Abdeen, A.R., Collen, S.B. & Vince, K.G. (2010) Fifteen‐year to 19‐year follow‐up of the Insall‐Burstein‐1 total knee arthroplasty. The Journal of Arthroplasty, 25, 173–178. Available from: https://doi.org/10.1016/J.ARTH.2009.01.009
Abdel, M.P., Morrey, M.E., Jensen, M.R. & Morrey, B.F. (2011) Increased long‐term survival of posterior cruciate‐retaining versus posterior cruciate‐stabilizing total knee replacements. Journal of Bone and Joint Surgery, 93, 2072–2078. Available from: https://doi.org/10.2106/JBJS.J.01143
Corona, P.S., Espinal, L., Rodríguez‐Pardo, D., Pigrau, C., Larrosa, N. & Flores, X. (2014) Antibiotic susceptibility in gram‐positive chronic joint arthroplasty infections: increased aminoglycoside resistance rate in patients with prior aminoglycoside‐impregnated cement spacer use. The Journal of Arthroplasty, 29, 1617–1621. Available from: https://doi.org/10.1016/J.ARTH.2014.03.029
Dinh, N.L., Chong, A.C., Walden, J.K., Adrian, S.C. & Cusick, R.P. (2016) Intrusion characteristics of high viscosity bone cements for the tibial component of a total knee arthroplasty using negative pressure intrusion cementing technique. The Iowa Orthopaedic Journal, 36, 161–166.
Dunne, N., Hill, J., McAfee, P., Todd, K., Kirkpatrick, R., Tunney, M. et al. (2007) In vitro study of the efficacy of acrylic bone cement loaded with supplementary amounts of gentamicin: effect on mechanical properties, antibiotic release, and biofilm formation. Acta Orthopaedica, 78, 774–785. Available from: https://doi.org/10.1080/17453670710014545
Ewald, F.C. (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clinical Orthopaedics and Related Research, 248, 9–12. Available from: https://doi.org/10.1097/00003086-198911000-00003
Guha, A.R., Debnath, U.K. & Graham, N.M. (2008) Radiolucent lines below the tibial component of a total knee replacement (TKR)—a comparison between single‐and two‐stage cementation techniques. International Orthopaedics, 32, 453–457. Available from: https://doi.org/10.1007/S00264-007-0345-6
Herndon, C.L., Grosso, M.J., Sarpong, N.O., Shah, R.P., Geller, J.A. & Cooper, H.J. (2020) Tibial cement mantle thickness is not affected by tourniquetless total knee arthroplasty when performed with tranexamic acid. Knee Surgery, Sports Traumatology, Arthroscopy, 28, 1526–1531. Available from: https://doi.org/10.1007/S00167-019-05559-3
Hinarejos, P., Fontanellas, A., Leal‐Blanquet, J., Sánchez‐Soler, J., Torres‐Claramunt, R. & Monllau, J.C. (2022) The technique of cement application has no influence on cement intrusion in total knee arthroplasty: randomized study comparing three different techniques. Knee Surgery, Sports Traumatology, Arthroscopy, 30, 1057–1064. Available from: https://doi.org/10.1007/s00167-021-06528-5
Klekamp, J., Dawson, J.M., Haas, D.W., DeBoer, D. & Christie, M. (1999) The use of vancomycin and tobramycin in acrylic bone cement. The Journal of Arthroplasty, 14, 339–346. Available from: https://doi.org/10.1016/S0883-5403(99)90061-X
Kopinski, J.E., Aggarwal, A., Nunley, R.M., Barrack, R.L. & Nam, D. (2016) Failure at the tibial cement‐implant interface with the use of high‐viscosity cement in total knee arthroplasty. The Journal of Arthroplasty, 31, 2579–2582. Available from: https://doi.org/10.1016/J.ARTH.2016.03.063
Lindén, U. (1989) Fatigue properties of bone cement. Acta Orthopaedica Scandinavica, 60, 431–433. Available from: https://doi.org/10.3109/17453678909149312
Lionberger, D., Wattenbarger, L., Conlon, C. & Walker, T.J. (2020) Factors affecting aseptic loosening in primary total knee replacements: an in vitro study. Journal of Experimental Orthopaedics, 7, 41. Available from: https://doi.org/10.1186/S40634-020-00243-9
Mann, K.A., Ayers, D.C., Werner, F.W., Nicoletta, R.J. & Fortino, M.D. (1997) Tensile strength of the cement‐bone interface depends on the amount of bone interdigitated with PMMA cement. Journal of Biomechanics, 30, 339–346. Available from: https://doi.org/10.1016/S0021-9290(96)00164-9
Di Maria, F., Das, S., Abermann, E., Hoser, C. & Fink, C. (2024) Pulsed lavage is associated with better quality of bone–cement–implant interface in knee arthroplasties (TKA/UKA) compared to syringe lavage in vitro; however, clinical data are missing: a systematic review. Journal of Experimental Orthopaedics, 11, e12027. Available from: https://doi.org/10.1002/jeo2.12027
Moran, J.M., Greenwald, A.S. & Matejczyk, M.B. (1979) Effect of gentamicin on shear and interface strengths of bone cement. Clinical Orthopaedics and Related Research, 141, 96–101. Available from: https://doi.org/10.1097/00003086-197906000-00011
Nagel, K., Bishop, N.E., Schlegel, U.J., Püschel, K. & Morlock, M.M. (2017) The influence of cement morphology parameters on the strength of the cement‐bone interface in tibial tray fixation. The Journal of Arthroplasty, 32, 563–569. Available from: https://doi.org/10.1016/J.ARTH.2016.08.013
Niesen, A.E., Tirumalai, P.A., Howell, S.M. & Hull, M.L. (2024) Risk of tibial baseplate loosening is low in patients following unrestricted kinematic alignment total knee arthroplasty using a cruciate‐retaining medial conforming insert: a study using radiostereometric analysis at 2 years. Knee Surgery, Sports Traumatology, Arthroscopy, 32, 693–703. Available from: https://doi.org/10.1002/KSA.12089
O'Donovan, P., McAleese, T. & Harty, J. (2023) Does lucency equate to revision? A five‐year retrospective review of Attune and Triathlon total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 31, 4773–4781. Available from: https://doi.org/10.1007/S00167-023-07509-6
Pfitzner, T., von Roth, P., Voerkelius, N., Mayr, H., Perka, C. & Hube, R. (2016) Influence of the tourniquet on tibial cement mantle thickness in primary total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 24, 96–101. Available from: https://doi.org/10.1007/S00167-014-3341-6
Pitta, M., Esposito, C.I., Li, Z., Lee, Y., Wright, T.M. & Padgett, D.E. (2018) Failure after modern total knee arthroplasty: a prospective study of 18,065 knees. The Journal of Arthroplasty, 33, 407–414. Available from: https://doi.org/10.1016/J.ARTH.2017.09.041
Rodriguez, J.A. & Bhende, H.R.C. (2001) Total condylar knee replacement: a 20‐year followup study. Clinical Orthopaedics and Related Research, 388, 10–17. Available from: https://doi.org/10.1097/00003086-200107000-00004
Schlegel, U.J., Püschel, K., Morlock, M.M. & Nagel, K. (2014) An in vitro comparison of tibial tray cementation using gun pressurization or pulsed lavage. International Orthopaedics, 38, 967–971. Available from: https://doi.org/10.1007/S00264-014-2303-4
Stadler, C., Hofstätter, M., Luger, M., Stöbich, M., Ruhs, B., Gotterbarm, T. et al. (2023) No component loosening of a cementless deep dish rotating platform knee at a 5‐year follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy, 31, 969–978. Available from: https://doi.org/10.1007/S00167-022-07113-0
Vanlommel, J., Luyckx, J.P., Labey, L., Innocenti, B., De Corte, R. & Bellemans, J. (2011) Cementing the tibial component in total knee arthroplasty. The Journal of Arthroplasty, 26, 492–496. Available from: https://doi.org/10.1016/j.arth.2010.01.107
Verburg, H., van de Ridder, L.C., Verhoeven, V.W. & Pilot, P. (2014) Validation of a measuring technique with computed tomography for cement penetration into trabecular bone underneath the tibial tray in total knee arthroplasty on a cadaver model. BMC Medical Imaging, 14, 29. Available from: https://doi.org/10.1186/1471-2342-14-29
Waanders, D., Janssen, D., Mann, K.A. & Verdonschot, N. (2010) The mechanical effects of different levels of cement penetration at the cement‐bone interface. Journal of Biomechanics, 43, 1167–1175. Available from: https://doi.org/10.1016/J.JBIOMECH.2009.11.033