Properties of antibiotic-loaded acrylic bone cements for use in cemented arthroplasties: a state-of-the-art review.

Infection of periprosthetic sites of total joint replacements has been widely reported. Although, by most accounts, the incidence of such events is low, the problem can prove to be expensive to remedy. In the case of cemented arthroplasties, a common management modality is the use of antibiotic-loaded acrylic bone cement (ALABC) as a prophylaxis or a therapeutic agent. Although there is a large literature on properties of ALABCs (on the order of 100 journal articles), a comprehensive review is lacking. The present contribution, whose objective is to fill this gap, is organized in four parts. Details of the background to and motivation for the work are given in the first part, explicative summaries of literature studies on the influence of various factors on an array of in vitro and in vivo properties of ALABCs are covered in the second part, issues and areas for future studies are presented in the third part, and the fourth part contains a summary of the most salient points made in the review.