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

Background and purpose -- High-dose dual antibioticloaded 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 = 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 single versus dual ALBC use. The crude cumulative 7-year THA re-revision and 9-year TKA re-revision rates did 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. [ABSTRACT FROM AUTHOR]

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