Revision procedures are mainly classified as aseptic, but in around 10% of the cases this is a false-negative diagnosis, and the loosening is caused by a periprosthetic joint infection (PJI).1
Given the higher likelihood of infection in revision arthroplasty and the catastrophic consequences of its occurrence2-3, the dual antibiotic-loaded bone cement COPAL® G+C supports the objective of more effective infection prevention.4
A retrospective study by Pablo Sanz-Ruiz reported that the use of dual antibiotic-loaded bone cement (DALBC) in aseptic revision total knee arthroplasty was associated with a significant reduction in PJI cases.
A PJI rate of 4.1% was found in the single antibiotic-loaded bone cement (SALBC) group (PALACOS®R+G) vs 0% in the COPAL® G+C group (p = 0.035). The relative risk reduction was 57%, the calculated total saving per patient was $1367.4
Aseptic revision carries the possibility of a low-grade infection.
Jacobs et al. with their study showed that up to 12% of all perceived aseptic knee and hip revisions showed positive cultures.
By using a dual antibiotic-loaded bone cement greater local antibiotic efficiency can be achieved – especially in revision procedures that in general have a higher risk of infection.5
Find out more about why it makes sense to consider aseptic cases as possible septic ones in the lecture of Jon H. M. Goosen, M.D.6
1 Jacobs et al., The unsuspected prosthetic joint infection – Incidence and consequences of positive intraoperative cultures in presumed aseptic knee and hip revision, Bone Joint J2017;99-B:1482–.9
2 Signore et al., Consensus document for the diagnosis of prosthetic joint infections: a joint paper by the EANM, EBJIS, and ESR (with ESCMID endorsement), European Journal of Nuclear Medicine and Molecular Imaging (2019) 46:971–988
3 McNally et al., The EBJIS definition of periprosthetic joint infection - A practical guide for clinicians, Bone Joint 2021;103-B(1):18–25
4 Sanz-Ruiz et al., 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 Volume 35, Issue 12, P3724-3729, December 1, 2020
5Jacobs et al., The unsuspected prosthetic joint infection – Incidence and consequences of positive intraoperative cultures in presumed aseptic knee and hip revision, Bone Joint J2017;99-B:1482–.9
6Full webinar "How can we improve PJI prevention?" available here
