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Biomet Cement and Cementing Systems


Antibiotic-loaded bone cement

Revisions

One-stage revisions
The incidence of revision varies from country to country. A sound surgical and cementing technique decreases the risk of revisions. Antibiotic therapy is a critical element of the treatment of infected hip and knee joints. Although the results of primary total hip and knee arthroplasties generally are excellent, some failures do occur over time4. During one-stage hip revision surgery, the implant and the former cement mantle is removed. After thorough lavage, and in some cases bone impaction, the acetabular and femoral components are fixed with an antibiotic-loaded cement.

Two-stage revisions
In a two-stage revision,a temporary spacer made of antibiotic-loaded cement may be used for local release of the antibiotic.This temporary cement spacer prevents bone-on-bone contact, prevents contraction of soft tissue and stabilises the infected joint. The non-weight-bearing spacer remains in place until the infection has been successfully treated. It is then removed and replaced with a conventional joint prostheses.

The molds can be used to produce temporary cement spacers for infected
joints. For these applications, an appropriate antibiotic-loaded cement should be used. The first stage is removal of the failed components and implantation of the cement spacer. During the implantation period of the temporary joint spacer, normally 6–8 weeks,local antibiotic therapy is rendered. The second stage is implantation of the new components.

The joint spacer molds are sterile disposables made of medical grade silicone. They can be filled with bone cement by injection with a cement delivery gun. After the cement cures, the temporary spacer is removed from the mold and placed into the joint spacer.