Purpose of Technology: Antibiotic bone cement (ABC) is a type of curable polymethylmethacrylate preparation created by adding various antibiotic medications to plain, nonmedicated bone cement. Most commonly, ABC is used to treat infected total joint prostheses as part of a revision arthroplasty, but its use as antibiotic prophylaxis in primary joint arthroplasty is increasing.

Rationale: The usage of ABC at the arthroplasty site may be useful in maintaining a locally high level of antibiotic drug concentration.

Controversy: Controversial issues related to the clinical use of ABCs in TKA include the safety and effectiveness of ABCs compared with other fixation methods, optimal antibiotic choice and dose, optimal cement preparation technique, cost-effectiveness of ABCs, the appropriate use of ABC in a prophylactic setting, and patient selection (i.e., which patients might benefit the most from the treatment).

Relevant Questions:

  • Is ABC effective in preventing infection in primary knee arthroplasty?
  • Is ABC effective in treating or preventing recurrence of infection in revision knee arthroplasty?
  • What harms and complications are associated with ABC? Are the rates of these harms different than those experienced with alternative treatments?
  • Have definitive patient selection criteria been established for the use of ABC in TKA?

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