Does antibiotic-loaded cement decrease the risk of aseptic failure in primary hip arthroplasty? A systematic review
DOI:
https://doi.org/10.1016/j.rccot.2016.11.004Keywords:
hip arthroplasty, bone cements, methylmethacrylate, prosthesis looseningAbstract
Background: The use of antibiotic cement has been shown to decrease the risk of periprosthetic hip infection. However, the long term effect of adding antibiotic to the bone cement continues being a controversial issue because of the possible change in its mechanical properties. The objective of this study is to identify the risk of long-term aseptic failure, with the use of antibiotic cement in primary hip arthroplasties.
Materials and methods: A systematic literature search in Medline, Embase and Cochrane data was performed studies evaluating long-term (≥10 years) risk of aseptic failure total primary hip replacement cemented with or without antibiotic were included. The methodological study assessment was performed using the Newcastle-Ottawa scale and Jadad.
Results: 5286 titles were identified. Four items were included in the analysis: 1 clinical trial of low quality and 3 prospective cohort of high quality. In the clinical trial, no differences in the risk of aseptical failure using antibiotic cement and regular cement (p = 0.14) were found. Unlike, the three cohorts consistently demonstrated a statistically significant reduction (p < 0.001) relative risk of aseptic failure at 10 years, with the use of antibiotic cement.
Discussion: The use of antibiotic cementfor hip arthroplasties fixation exerts a protective effect and reduces the relative risk of long-term aseptic failure.
Level of clinical evidence: II.
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