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During total joint arthroplasty (TJA), antibiotic-loaded bone cement (ALBC) is frequently used to treat or prevent periprosthetic joint infections (PJI).
In two-stage exchange arthroplasty, ALBC is frequently utilized in conjunction with custom spacers, beads, rods, and static and dynamic spacers.
An established treatment for periprosthetic joint infections is the use of antibiotic-loaded cement spacers. After the spacer is inserted and during the second stage, sufficient pharmacokinetic properties are documented in the literature.
There are numerous potential systemic and mechanical issues. For the treatment of infected joint arthroplasties and prophylaxes in some cases of total joint replacement, antibiotic-loaded bone cement was developed.
The antibiotics gentamicin, cefuroxime, and tobramycin are those that are used in clinical studies the most frequently in bone cement all over the world. Gentamicin has been used the most and studied the most of the three antibiotics.
During the elution test, neither of the drugs affected the other. Relevance to medicine: According to the findings of this study, bone cement and streptomycin, amoxicillin, and clavulanate in combination are effective for 30 days.
Patients are allowed to move around with a walker or wheelchair after the spacers have been in for about six weeks. A second spacer may be required to completely eradicate infection in some instances, depending on the severity of the issue.
The Global antibiotic-loaded bone cement market accounted for $XX Billion in 2022 and is anticipated to reach $XX Billion by 2030, registering a CAGR of XX% from 2024 to 2030.
Hsu et al measured the in vitro elution characteristics and antibacterial capacities of bone cement specimens loaded with either 4 g of vancomycin or teicoplanin and 4 g of ceftazidime, imipenem, or aztreonam.
Eight patients with chronic PJI were given the best combination to test the in vivo drug dose and bioactivity. In another prospective study of gentamycin-clindamycin-loaded cement, 32 subjects were divided into two groups.
Vancomycin and ceftazidime were chosen as the best option because they demonstrated good capabilities in both the laboratory and clinical setting.
Patients with PJI underwent a one-stage exchange, while aseptic loosening patients were considered to be at high risk for infection and underwent revision or primary arthroplasty.
A retrospective study on daptomycin- and tobramycin-loaded cement reported a cure rate of 92% (11/12) for patients who had any MRSA infection during the evaluation period, compared to 62% (13/21) for patients with MSSA.
There was no reinfection at the conclusion of the 5-year follow-up.[67] The disparity might be caused by the use of antibiotics throughout the body, which could not be balanced in this kind of trial. The presence of tobramycin also led to an increase in the amount of daptomycin released into the joint fluid.
