Sergi Gil-Gonzalez, Borja Velasco-Regúlez, Jesus Cerquides, Pedro Hinarejos, Joan Carles Monllau, Xavier Pelfort
{"title":"抗生素骨水泥可降低全膝关节置换术的翻修风险：加泰罗尼亚关节置换登记分析。","authors":"Sergi Gil-Gonzalez, Borja Velasco-Regúlez, Jesus Cerquides, Pedro Hinarejos, Joan Carles Monllau, Xavier Pelfort","doi":"10.1002/ksa.12361","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to analyse the impact on peri-prosthetic joint infection (PJI) rate and prosthetic survival using antibiotic-loaded bone cement (ALBC) versus plain cement during total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted. The main data source was the Catalan Arthroplasty Register (RACat). TKAs with surgery date between 1 January 2011 and 31 December 2020 were analysed and followed up until 31 December 2023. The main variable of interest was the type of cement (ALBC vs. plain cement), and several endpoints (septic revision, aseptic revision, and all-cause revision) were considered. The analysed outcomes were revision rates, survival rates and risk factors' hazard ratios (HR).</p><p><strong>Results: </strong>A total of 22,781 TKAs were analysed, 13,125 (57.6%) of them with plain cement and 9656 (42.4%) with ALBC. The septic revision rate was lower in the ALBC group after 3 months of follow-up (0.52% vs. 0.78%, p value = 0.04). Prosthetic survival with respect to the aseptic revision endpoint was also higher for the ALBC group during the whole follow-up period (~158 months). Regarding risk factors for infection, ALBC showed a protective effect, HR: 0.53 (0.44, 0.63), while sex (being male) and the analysed comorbidities increased the risk.</p><p><strong>Conclusions: </strong>ALBC is associated with a reduction in both the septic revision and the aseptic revision rate after TKA, and thus with higher prosthetic survival.</p><p><strong>Level of evidence: </strong>Level III, Therapeutic, retrospective.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":"354-363"},"PeriodicalIF":3.3000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11716362/pdf/","citationCount":"0","resultStr":"{\"title\":\"Antibiotic-loaded bone cement is associated with a reduction of the risk of revision of total knee arthroplasty: Analysis of the Catalan Arthroplasty Register.\",\"authors\":\"Sergi Gil-Gonzalez, Borja Velasco-Regúlez, Jesus Cerquides, Pedro Hinarejos, Joan Carles Monllau, Xavier Pelfort\",\"doi\":\"10.1002/ksa.12361\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The purpose of this study was to analyse the impact on peri-prosthetic joint infection (PJI) rate and prosthetic survival using antibiotic-loaded bone cement (ALBC) versus plain cement during total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted. The main data source was the Catalan Arthroplasty Register (RACat). TKAs with surgery date between 1 January 2011 and 31 December 2020 were analysed and followed up until 31 December 2023. The main variable of interest was the type of cement (ALBC vs. plain cement), and several endpoints (septic revision, aseptic revision, and all-cause revision) were considered. The analysed outcomes were revision rates, survival rates and risk factors' hazard ratios (HR).</p><p><strong>Results: </strong>A total of 22,781 TKAs were analysed, 13,125 (57.6%) of them with plain cement and 9656 (42.4%) with ALBC. The septic revision rate was lower in the ALBC group after 3 months of follow-up (0.52% vs. 0.78%, p value = 0.04). Prosthetic survival with respect to the aseptic revision endpoint was also higher for the ALBC group during the whole follow-up period (~158 months). Regarding risk factors for infection, ALBC showed a protective effect, HR: 0.53 (0.44, 0.63), while sex (being male) and the analysed comorbidities increased the risk.</p><p><strong>Conclusions: </strong>ALBC is associated with a reduction in both the septic revision and the aseptic revision rate after TKA, and thus with higher prosthetic survival.</p><p><strong>Level of evidence: </strong>Level III, Therapeutic, retrospective.</p>\",\"PeriodicalId\":17880,\"journal\":{\"name\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"volume\":\" \",\"pages\":\"354-363\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11716362/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12361\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12361","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/21 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Antibiotic-loaded bone cement is associated with a reduction of the risk of revision of total knee arthroplasty: Analysis of the Catalan Arthroplasty Register.
Purpose: The purpose of this study was to analyse the impact on peri-prosthetic joint infection (PJI) rate and prosthetic survival using antibiotic-loaded bone cement (ALBC) versus plain cement during total knee arthroplasty (TKA).
Methods: A retrospective cohort study was conducted. The main data source was the Catalan Arthroplasty Register (RACat). TKAs with surgery date between 1 January 2011 and 31 December 2020 were analysed and followed up until 31 December 2023. The main variable of interest was the type of cement (ALBC vs. plain cement), and several endpoints (septic revision, aseptic revision, and all-cause revision) were considered. The analysed outcomes were revision rates, survival rates and risk factors' hazard ratios (HR).
Results: A total of 22,781 TKAs were analysed, 13,125 (57.6%) of them with plain cement and 9656 (42.4%) with ALBC. The septic revision rate was lower in the ALBC group after 3 months of follow-up (0.52% vs. 0.78%, p value = 0.04). Prosthetic survival with respect to the aseptic revision endpoint was also higher for the ALBC group during the whole follow-up period (~158 months). Regarding risk factors for infection, ALBC showed a protective effect, HR: 0.53 (0.44, 0.63), while sex (being male) and the analysed comorbidities increased the risk.
Conclusions: ALBC is associated with a reduction in both the septic revision and the aseptic revision rate after TKA, and thus with higher prosthetic survival.
Level of evidence: Level III, Therapeutic, retrospective.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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