Outcomes of Patients Treated With Antibiotic-Loaded Acryl Bone Cement For Periprosthetic Hip Infection, Stratified By Cement Polymerization Temperature: A Retrospective Study

Background: Two-stage revision surgery using antibiotic-loaded acryl bone cement (ALAC) is an effective treatment for periprosthetic joint infection (PJI) after hip arthroplasty. However, ALAC has been reported to release different amounts of antibacterial agents, depending on the type of bone cement used. No previous study has examined patient outcomes based on the polymerization temperature of the bone cement used. This study aimed to compare the outcomes of patients who underwent a two-stage revision surgery using ALAC for PJI, stratified by the polymerization temperature of the bone cement used.Methods: This study involved 23 joints in 23 patients treated with ALAC between 1993 and 2019. They were classified into normal (control group, n=12) and low polymerization temperature (L group, n=11) groups, respectively. Patient outcomes were compared between the groups.Results: In both groups, the infection subsiding rate was 100%. The success rate of revision surgery at the 2-year follow-up was 82.6%. There was no difference between the groups in mean age, time to infection onset, patient general condition, presence of fistulas, or methicillin-resistant Staphylococcus aureus infection. However, the infection required less time to subside, and fewer beads or spacers were used in the L group than in the control group. The success rate of revision surgery was 66.7% and 100% in the control and L groups, respectively.Conclusions: In the present study, two-stage revision surgery with ALAC in PJI was associated with a shorter infection subsidence period and fewer surgeries in the group treated with bone cement of low polymerization temperature than in the control group. The use of bone cement of low polymerization temperature in ALAC is an effective treatment option for PJI.