Risk for re-revision and type of antibiotic-loaded bone cement in hip or knee arthroplasty revisions: report of the Dutch Arthroplasty Register

Pieter K. Bos; Anneke Spekenbrink-Spooren; Peter Croughs; Sita M.A. Bierma-Zeinstra; Max Reijman; Jakob Van Oldenrijk

doi:10.2340/17453674.2023.18645

Risk for re-revision and type of antibiotic-loaded bone cement in hip or knee arthroplasty revisions: report of the Dutch Arthroplasty Register

Pieter K. Bos^*, Anneke Spekenbrink-Spooren, Peter Croughs, Sita M.A. Bierma-Zeinstra, Max Reijman, Jakob Van Oldenrijk

^*Corresponding author for this work

Dutch National Arthroplasty Registry (LROI)

Research output: Contribution to journal › Article › Academic › peer-review

4 Citations (Scopus)

39 Downloads (Pure)

Abstract

Background and purpose:

High-dose dual antibiotic-loaded bone cement (ALBC) may reduce the risk of revision after total hip and knee replacements. The aim of our study therefore was to determine the risk of re-revision following first time aseptic hip or knee revision using single versus dual ALBC.

Patients and methods:

Patients from the Dutch Arthroplasty Register treated from 2007 to 2018 with first time cemented aseptic hip (n = 2,529) or knee revisions (n = 7,124) were incorporated into 2 datasets. The primary endpoint of this observational cohort study was subsequent all-cause re-revision. Multivariable Cox proportional hazard and competing risk was analyzed for both groups.

Results:

There was no difference in re-revision rate (any reason) with single versus dual ALBC (hazard ratio 1.06, 95% confidence interval [CI] 0.83–1.35 for hip and 0.93, CI 0.80–1.07 for knee revisions). The 10-year crude cumulative re-revision rate also showed no differences for single versus dual ALBC use. The crude cumulative 7-year THA re-revision and 9-year TKA re-revision rates did not show any difference in implant survival for common cement types used.

Conclusion:

We could not confirm the potential benefit of using dual ALBC compared with single ALBC for aseptic hip and knee revisions.

Original language	English
Pages (from-to)	471-476
Number of pages	6
Journal	Acta Orthopaedica
Volume	94
DOIs	https://doi.org/10.2340/17453674.2023.18645
Publication status	Published - 2023

Bibliographical note

Publisher Copyright:
© 2023 The Author(s). Published by Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation.

Ethics, funding, and disclosures:
The research protocol was approved by the scientific committee of the LROI and is following the regulations of the
LROI. All data is anonymous, therefore ethical approval from
our local ethical commission was not applicable. We did not
receive any funding for this study. JvO has an advisory consulting agreement with Heraeus, not related to the subject of
this paper. Complete disclosure of interests statement forms
according to ICMJE are available at the article page, doi:
10.2340/17453674.2023.18645

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10.2340/17453674.2023.18645Licence: CC BY-NC

Risk for re-revision and type of antibiotic-loaded bone cement in hip or knee arthroplasty revisionsFinal published version, 916 KBLicence: CC BY-NC

Cite this

@article{1b1a272afebf476b8e7542dd7029c89a,

title = "Risk for re-revision and type of antibiotic-loaded bone cement in hip or knee arthroplasty revisions: report of the Dutch Arthroplasty Register",

abstract = "Background and purpose:High-dose dual antibiotic-loaded bone cement (ALBC) may reduce the risk of revision after total hip and knee replacements. The aim of our study therefore was to determine the risk of re-revision following first time aseptic hip or knee revision using single versus dual ALBC. Patients and methods:Patients from the Dutch Arthroplasty Register treated from 2007 to 2018 with first time cemented aseptic hip (n = 2,529) or knee revisions (n = 7,124) were incorporated into 2 datasets. The primary endpoint of this observational cohort study was subsequent all-cause re-revision. Multivariable Cox proportional hazard and competing risk was analyzed for both groups. Results:There was no difference in re-revision rate (any reason) with single versus dual ALBC (hazard ratio 1.06, 95\% confidence interval [CI] 0.83–1.35 for hip and 0.93, CI 0.80–1.07 for knee revisions). The 10-year crude cumulative re-revision rate also showed no differences for single versus dual ALBC use. The crude cumulative 7-year THA re-revision and 9-year TKA re-revision rates did not show any difference in implant survival for common cement types used. Conclusion:We could not confirm the potential benefit of using dual ALBC compared with single ALBC for aseptic hip and knee revisions.",

author = "Bos, \{Pieter K.\} and Anneke Spekenbrink-Spooren and Peter Croughs and Bierma-Zeinstra, \{Sita M.A.\} and Max Reijman and \{Van Oldenrijk\}, Jakob",

note = "Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation. Ethics, funding, and disclosures: The research protocol was approved by the scientific committee of the LROI and is following the regulations of the LROI. All data is anonymous, therefore ethical approval from our local ethical commission was not applicable. We did not receive any funding for this study. JvO has an advisory consulting agreement with Heraeus, not related to the subject of this paper. Complete disclosure of interests statement forms according to ICMJE are available at the article page, doi: 10.2340/17453674.2023.18645",

year = "2023",

doi = "10.2340/17453674.2023.18645",

language = "English",

volume = "94",

pages = "471--476",

journal = "Acta Orthopaedica",

issn = "1745-3674",

publisher = "Medical Journals Sweden AB",

}

TY - JOUR

T1 - Risk for re-revision and type of antibiotic-loaded bone cement in hip or knee arthroplasty revisions

T2 - report of the Dutch Arthroplasty Register

AU - Bos, Pieter K.

AU - Spekenbrink-Spooren, Anneke

AU - Croughs, Peter

AU - Bierma-Zeinstra, Sita M.A.

AU - Reijman, Max

AU - Van Oldenrijk, Jakob

N1 - Publisher Copyright: © 2023 The Author(s). Published by Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation. Ethics, funding, and disclosures: The research protocol was approved by the scientific committee of the LROI and is following the regulations of the LROI. All data is anonymous, therefore ethical approval from our local ethical commission was not applicable. We did not receive any funding for this study. JvO has an advisory consulting agreement with Heraeus, not related to the subject of this paper. Complete disclosure of interests statement forms according to ICMJE are available at the article page, doi: 10.2340/17453674.2023.18645

PY - 2023

Y1 - 2023

N2 - Background and purpose:High-dose dual antibiotic-loaded bone cement (ALBC) may reduce the risk of revision after total hip and knee replacements. The aim of our study therefore was to determine the risk of re-revision following first time aseptic hip or knee revision using single versus dual ALBC. Patients and methods:Patients from the Dutch Arthroplasty Register treated from 2007 to 2018 with first time cemented aseptic hip (n = 2,529) or knee revisions (n = 7,124) were incorporated into 2 datasets. The primary endpoint of this observational cohort study was subsequent all-cause re-revision. Multivariable Cox proportional hazard and competing risk was analyzed for both groups. Results:There was no difference in re-revision rate (any reason) with single versus dual ALBC (hazard ratio 1.06, 95% confidence interval [CI] 0.83–1.35 for hip and 0.93, CI 0.80–1.07 for knee revisions). The 10-year crude cumulative re-revision rate also showed no differences for single versus dual ALBC use. The crude cumulative 7-year THA re-revision and 9-year TKA re-revision rates did not show any difference in implant survival for common cement types used. Conclusion:We could not confirm the potential benefit of using dual ALBC compared with single ALBC for aseptic hip and knee revisions.

AB - Background and purpose:High-dose dual antibiotic-loaded bone cement (ALBC) may reduce the risk of revision after total hip and knee replacements. The aim of our study therefore was to determine the risk of re-revision following first time aseptic hip or knee revision using single versus dual ALBC. Patients and methods:Patients from the Dutch Arthroplasty Register treated from 2007 to 2018 with first time cemented aseptic hip (n = 2,529) or knee revisions (n = 7,124) were incorporated into 2 datasets. The primary endpoint of this observational cohort study was subsequent all-cause re-revision. Multivariable Cox proportional hazard and competing risk was analyzed for both groups. Results:There was no difference in re-revision rate (any reason) with single versus dual ALBC (hazard ratio 1.06, 95% confidence interval [CI] 0.83–1.35 for hip and 0.93, CI 0.80–1.07 for knee revisions). The 10-year crude cumulative re-revision rate also showed no differences for single versus dual ALBC use. The crude cumulative 7-year THA re-revision and 9-year TKA re-revision rates did not show any difference in implant survival for common cement types used. Conclusion:We could not confirm the potential benefit of using dual ALBC compared with single ALBC for aseptic hip and knee revisions.

UR - https://www.scopus.com/pages/publications/85172360809

U2 - 10.2340/17453674.2023.18645

DO - 10.2340/17453674.2023.18645

M3 - Article

C2 - 37728200

AN - SCOPUS:85172360809

SN - 1745-3674

VL - 94

SP - 471

EP - 476

JO - Acta Orthopaedica

JF - Acta Orthopaedica

ER -

Risk for re-revision and type of antibiotic-loaded bone cement in hip or knee arthroplasty revisions: report of the Dutch Arthroplasty Register

Abstract

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