{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:45:46Z","timestamp":1793825146371,"version":"4.6.1"},"reference-count":71,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Despite increased use of antibiotic-loaded bone cement (ALBC) in joint arthroplasty over recent decades, current evidence for prophylactic use of ALBC to reduce risk of periprosthetic joint infection (PJI) is insufficient.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare the rate of revision attributed to PJI following primary total knee arthroplasty (TKA) using ALBC vs plain bone cement.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This international cohort study used data from 14 national or regional joint arthroplasty registries in Australia, Denmark, Finland, Germany, Italy, New Zealand, Norway, Romania, Sweden, Switzerland, the Netherlands, the UK, and the US. The study included primary TKAs for osteoarthritis registered from January 1, 2010, to December 31, 2020, and followed-up until December 31, 2021. Data analysis was performed from April to September 2023.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Primary TKA with ALBC vs plain bone cement.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was risk of 1-year revision for PJI. Using a distributed data network analysis method, data were harmonized, and a cumulative revision rate was calculated (1\u2009\u2212\u2009Kaplan-Meier), and Cox regression analyses were performed within the 10 registries using both cement types. A meta-analysis was then performed to combine all aggregated data and evaluate the risk of 1-year revision for PJI and all causes.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 2\u202f168\u202f924 TKAs included, 93% were performed with ALBC. Most TKAs were performed in female patients (59.5%) and patients aged 65 to 74 years (39.9%), fully cemented (92.2%), and in the 2015 to 2020 period (62.5%). All participating registries reported a cumulative 1-year revision rate for PJI of less than 1% following primary TKA with ALBC (range, 0.21%-0.80%) and with plain bone cement (range, 0.23%-0.70%). The meta-analyses based on adjusted Cox regression for 1\u202f917\u202f190 TKAs showed no statistically significant difference at 1 year in risk of revision for PJI (hazard rate ratio, 1.16; 95% CI, 0.89-1.52) or for all causes (hazard rate ratio, 1.12; 95% CI, 0.89-1.40) among TKAs performed with ALBC vs plain bone cement.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this study, the risk of revision for PJI was similar between ALBC and plain bone cement following primary TKA. Any additional costs of ALBC and its relative value in reducing revision risk should be considered in the context of the overall health care delivery system.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.12898","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T15:33:43Z","timestamp":1716478423000},"page":"e2412898","source":"Crossref","is-referenced-by-count":41,"title":["Periprosthetic Joint Infection After Total Knee Arthroplasty With or Without Antibiotic Bone Cement"],"prefix":"10.1001","volume":"7","author":[{"given":"Tesfaye H.","family":"Leta","sequence":"first","affiliation":[{"name":"The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway"},{"name":"Faculty of Health Science, VID Specialized University, Oslo, Norway"},{"name":"Department of Population Health Sciences, Weill Medical College of Cornell University, New York, New York"},{"name":"Medical Device Surveillance and Assessment, Kaiser Permanente, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stein Atle","family":"Lie","sequence":"additional","affiliation":[{"name":"The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway"},{"name":"Center for Translational Oral Research, Department of Dentistry, University of Bergen, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Marie","family":"Fenstad","sequence":"additional","affiliation":[{"name":"The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stein H\u00e5kon L.","family":"Lygre","sequence":"additional","affiliation":[{"name":"The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, Norway"},{"name":"Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Lindberg-Larsen","sequence":"additional","affiliation":[{"name":"The Danish Knee Arthroplasty Register, Odense, Denmark"},{"name":"Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alma B.","family":"Pedersen","sequence":"additional","affiliation":[{"name":"The Danish Knee Arthroplasty Register, Odense, Denmark"},{"name":"Department of Clinical Epidemiology, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"W-Dahl","sequence":"additional","affiliation":[{"name":"The Swedish Arthroplasty Register, Gothenburg, Sweden"},{"name":"Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Rolfson","sequence":"additional","affiliation":[{"name":"The Swedish Arthroplasty Register, Gothenburg, Sweden"},{"name":"Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"B\u00fclow","sequence":"additional","affiliation":[{"name":"Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Centre of Registers V\u00e4stra G\u00f6taland, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liza N.","family":"van Steenbergen","sequence":"additional","affiliation":[{"name":"The Dutch Arthroplasty Register, \u2018s-Hertogenbosch, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob G. 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