ArticleJournal of orthopaedic research : official publication of the Orthopaedic Research Society2021
Adjuvant antibiotic-loaded bone cement: Concerns with current use and research to make it work.
Article in Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers.
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Who cites it
77 citing papers in PubMed, 146 citations in OpenAlex.
- Application and Clinical Effectiveness of Antibiotic-Loaded Bone Cement to Promote Soft Tissue Granulation in the Treatment of Neuropathic Diabetic Foot Ulcers Complicated by Osteomyelitis: A Randomized Controlled Trial.Journal of diabetes research · 2021Trial
- Current and emerging antibacterial strategies for periprosthetic joint infection: An overview.Bioactive materials · 2026Review
- Local antibiotic treatment for periprosthetic joint infection: current approaches and the emerging role of continuous local antibiotic perfusion.International orthopaedics · 2026Review
- Prophylactic Antibiotic-Loaded Cement, Absorbable and Nonabsorbable, for Implant-Based Breast Reconstruction.Aesthetic surgery journal · 2026Article
- Single versus dual antibiotic-loaded bone cement in hip fracture arthroplasty: a cohort study of 56,434 hip arthroplasties from the Dutch Arthroplasty Register.Acta orthopaedica · 2026Article
- A multi-modal strategy for enhancing titanium-bone interface strength and antimicrobial properties of PMMA bone cements.Materials & design · 2026Article
- Multifunctional MoS₂-PMMA bone cement with enhanced strength and antibacterial activity to overcome limitations of conventional materials in orthopedic surgery.BMC musculoskeletal disorders · 2026Article
- Effects of hydroxybisphosphonates-conjugated sitafloxacin on fracture healing and skeletal growth in mice.JBMR plus · 2026Article
- ["Chongqing experiences" in treatment of bone infections].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Review
- Unilateral biportal endoscopic debridement with antibiotic-loaded cement beads implantation for lumbar spinal infection: a preliminary report on feasibility and early clinical outcomes.Frontiers in cellular and infection microbiology · 2026Article
- Effects of Antibiotic-Loaded Bone Cement on the Risk of Periprosthetic Joint Infection in Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.The archives of bone and joint surgery · 2026Review
- CarboCell G/C provides sustained high local bone antibiotic levels with minimal systemic exposure, supporting its therapeutic potential in orthopedic infection management.Journal of bone and joint infection · 2026Article
- Dual-antibiotic bone cement (gentamicin + vancomycin) in preventing and treating infections during revision knee arthroplasty in high-risk patients.Journal of experimental orthopaedics · 2026Article
- Injectable sustained local release doxorubicin depot technology- a promising adjuvant to systemic treatment?Drug delivery and translational research · 2025Article
- Ion-paired antibiotics in PLGA nanoparticles: improving encapsulation efficiency and musculoskeletal infection treatment.RSC advances · 2025Article
- Dual chitosan hydrogel and polylactic acid microparticle delivery system reduces Staphylococcal osteomyelitis and soft tissue infection.NPJ biofilms and microbiomes · 2025Article
- Clinical outcomes of continuous local antibiotic perfusion in combination with debridement antibiotics and implant retention for periprosthetic hip joint infection.Scientific reports · 2025Article
- Surgical management of fracture-related infection (FRI) in the proximal femur: treatment options and long-term outcome.BMC musculoskeletal disorders · 2025Article
- Orthopaedic infections: novel treatment strategies and evolving concepts.OTA international : the open access journal of orthopaedic trauma · 2025Article
- Borosilicate bioactive glass synergizing low-dose antibiotic loaded implants to combat bacteria through ATP disruption and oxidative stress to sequentially achieve osseointegration.Bioactive materials · 2025Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
30 authors at 20 institutions in 8 countries.
Funding
Abstract
Antibiotic-loaded bone cement (ALBC) is broadly used to treat orthopaedic infections based on the rationale that high-dose local delivery is essential to eradicate biofilm-associated bacteria. However, ALBC formulations are empirically based on drug susceptibility from routine laboratory testing, which is known to have limited clinical relevance for biofilms. There are also dosing concerns with nonstandardized, surgeon-directed, hand-mixed formulations, which have unknown release kinetics. On the basis of our knowledge of in vivo biofilms, pathogen virulence, safety issues with nonstandardized ALBC formulations, and questions about the cost-effectiveness of ALBC, there is a need to evaluate the evidence for this clinical practice. To this end, thought leaders in the field of musculoskeletal infection (MSKI) met on 1 August 2019 to review and debate published and anecdotal information, which highlighted four major concerns about current ALBC use: (a) substantial lack of level 1 evidence to demonstrate efficacy; (b) ALBC formulations become subtherapeutic following early release, which risks induction of antibiotic resistance, and exacerbated infection from microbial colonization of the carrier; (c) the absence of standardized formulation protocols, and Food and Drug Administration-approved high-dose ALBC products to use following resection in MSKI treatment; and (d) absence of a validated assay to determine the minimum biofilm eradication concentration to predict ALBC efficacy against patient specific micro-organisms. Here, we describe these concerns in detail, and propose areas in need of research.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.