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Antibiotic Impregnated Cement for Hip or Knee Arthroplasty: Clinical and Cost-Effectiveness

Last updated: September 30, 2015
Project Number: RC0702-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of antibiotic impregnated cement for patients undergoing a primary hip or knee arthroplasty?
  2. What is the cost-effectiveness of antibiotic impregnated cement for patients undergoing a primary hip or knee arthroplasty?

Key Message

Three systematic reviews with meta-analysis, one systemic review with network meta-analysis, three non-randomized studies, and two economic evaluations were identified regarding the clinical and cost-effectiveness of antibiotic impregnated cement for patients undergoing a primary hip or knee arthroplasty. The clinical evidence was of varying quality with particular concern regarding adjustment for confounders and heterogeneity. While there was limited evidence supporting lower infection rates and reduced antibiotic resistance, much of the evidence suggested no difference in effectiveness between antibiotic impregnated cement and plain cement. Antibiotic impregnated cement may provide a greater net monetary benefit over other infection control measures in total hip arthroplasty, but given the uncertainty in the clinical evidence base the economic evidence should be interpreted with caution.