An Important Backdrop to the Continued Discussion on the Use of Antibiotic-Containing Bone Cements

Abstract

The use of antibiotic-containing polymethylmethacrylate, or antibiotic PMMA, in revision of a total hip or total knee replacement due to a previous infection is currently accepted practice. Additionally, despite lack of regulatory approval in the United States, the “off-label” use of antibiotic PMMA for primary arthroplasty by orthopaedic surgeons is substantial and has continued to increase. The widespread use of antibiotic PMMA in total joint replacement provides ample clinical relevance to the article by Meyer et al. regarding the effects of vacuum-mixing on six widely used antibiotic PMMA formulations. One of the strengths of the work is the logical study design. The authors utilize a previously reported methodology for creating pellets of uniform consistency with virtually identical geometry1. Thirty pellets of each antibiotic (fifteen vacuum-mixed and fifteen atmospheric) were evaluated each day during a five-day elution protocol and were compared between groups as …