2026-06-01T02:22:39Zhttps://docta.ucm.es/rest/oai/request

oai:docta.ucm.es:20.500.14352/1175462025-02-04T01:05:20Zcom_20.500.14352_14col_20.500.14352_15

Is Dual Antibiotic-Loaded Bone Cement More Effective and Cost- Efficient Than a Single Antibiotic-Loaded Bone Cement to Reduce the Risk of Prosthetic Joint Infection in Aseptic Revision Knee Arthroplasty? Sanz Ruiz, Pablo Matas Diez, Jose Antonio Villaneuva-Martinez, Manuel Dos Santos-Vaquinha, Alex Vaquero Martín, Francisco Javier 616.7-76-089 Dual antibiotic-loaded cement Aseptic revision Prosthetic joint infection COPAL Infection cost Sistema musculoesquelético 3213.10 Cirugía Ortopédica Background: Higher rates of prosthetic joint infections (PJIs) are related to patient risk factors and/or to special surgical procedures such as revision total knee arthroplasty (rTKA). Among the measures discussed to better protect those patients from the higher infection risks use of dual antibiotic-loaded bone cement has emerged as a further prophylactic option. Methods: This retrospective study included 246 patients undergoing strictly aseptic revision knee arthroplasty at our institution in the time period 2015-2018. Based on the type of bone cement used for the cementation of the revision prosthesis, 2 groups were defined. In total, 143 patients received the low-dose single antibiotic-loaded bone cement (SALBC) PALACOS R+G and 103 patients received the high-dose dual antibiotic-loaded bone cement (DALBC) COPAL G+C. The number of PJI cases in each group over a follow-up time of minimum 1 year was compared and the extra costs for the DALBC use calculated against the economic savings per each avoided PJI case on basis of 3 different assumptions (treatment costs and amount of cement use). Results: Use of DALBC in aseptic rTKA was associated with a significant reduction in PJI cases (relative risk = 57%, PJI rate in the SALBC group 4.1% vs 0% in the DALBC group, P = 0.035). The calculated total savings per patient was $1367. Depending on the economic assumptions the range of savings was between $1413 (less favorable calculation model) and $3661 (most favorable calculation model). Conclusion: The use of DALBC in rTKA has been found to be more effective in preventing PJI and proved cost-efficient in all our cost-calculation models. Depto. de Cirugía Fac. de Medicina TRUE pub 2025-02-03T07:27:15Z 2025-02-03T07:27:15Z 2020-06-20 journal article VoR https://hdl.handle.net/20.500.14352/117546 XXXX-XXXX 10.1016/j.arth.2020.06.045 eng Sanz-Ruiz, P., Matas-Diez, J. A., Villanueva-Martínez, M., Santos-Vaquinha Blanco, A. D., & Vaquero, J. (2020). Is dual antibiotic-loaded bone cement more effective and cost-efficient than a single antibiotic-loaded bone cement to reduce the risk of prosthetic joint infection in aseptic revision knee arthroplasty? The Journal of Arthroplasty, 35(12), 3724-3729. https://doi.org/10.1016/j.arth.2020.06.045 restricted access application/pdf Elservier