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Antibiotic-loaded bone cement did not reduce infection rate in TJA
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Use of antibiotic-loaded bone cement in total joint arthroplasty did not significantly reduce the rate of infection and may be an unnecessary financial burden to the health care system, according to results presented at the Orthopaedic Research Society Annual Meeting.
In a retrospective review, James Wittig, MD, and colleagues identified 3,968 total knee arthroplasty cases, of which 3,442 received plain cement and 526 received antibiotic-loaded bone cement, and 148 total hip arthroplasty cases, of which 71 received plain cement and 77 received antibiotic-loaded bone cement.
Results showed readmission due to deep infection occurred in 13 patients who underwent TKA. Of these 13 patients, researchers found no statistically significant difference in infection rates between cements, with plain cement used in 0.29% of patients and antibiotic-loaded bone cement used in 0.57% of patients.
Researchers noted a total of 989 and 130 bags of antibiotic-loaded cement were used in 526 knee and 77 hip surgeries, respectively. With the cost of one bag of antibiotic-loaded bone cement set at $363.23 for THA and $335.96 for TKA, the total cost was $47,219.90 for THA cases and $332,264.44 for TKA cases, according to results. Researchers found a cost difference of $298,500.70 if plain cement had been used for the same procedures.
“As hospitals continue to find ways to improve both patient care and affordability in the wake of bundled payment models and changing payment methods, providers must reduce unnecessary costs in order to increase quality and improve efficiency — and this study proves that plain cement is as effective and more cost-effective than [antibiotic-loaded bone cement] ALBC,” Wittig, chair of orthopedic surgery and medical director of orthopedics, orthopedic oncology and sarcoma surgery at Atlantic Health System, said in a press release. – by Casey Tingle
Reference:
Hoskins T, et al. Poster 2211. Presented at: Orthopaedic Research Society Annual Meeting; Feb. 2-5, 2019; Austin, Texas.
Disclosure: Wittig reports no relevant financial disclosures.