Is there sufficient evidence to support the use of antibiotic-loaded cement in primary total knee arthroplasty (TKA) or total hip arthroplasty (THA) to reduce the risk of surgical site infections/periprosthetic joint infections (SSIs/PJIs)?

Authors: Yale Fillingham, Ali Parsa, Sergei Oshkukov, A. Seth Greenwald

RECOMMENDATION: There is no conclusive evidence to demonstrate that routine use of antibiotic-loaded cement in primary TKA or THA reduces
the risk of subsequent SSIs/PJIs. Recent high level evidence and registry data has not demonstrated a reduction in SSI/PJIs. Furthermore, the added
cost, the potential for the emergence of resistant organisms and the potential adverse eff ect of antibiotics on the host provide adequate reasons
to refrain from routine use of antibiotic loaded cement during primary total joint arthroplasty.

LEVEL OF EVIDENCE: Moderate

DELEGATE VOTE: Agree: 38%, Disagree: 58%, Abstain: 4% (NO Consensus)

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