A prospective, randomized study was conducted to evaluate the efficacy
of cefuroxime-impregnated cement in the prevention of deep infection
after primary total knee arthroplasties performed without so-called
clean-air measures, such as laminar flow and body-exhaust suits.
Three hundred and forty primary total knee arthroplasties were
performed with cementless fixation of the femoral component and
cement fixation of the patellar and tibial components. The knees
were randomly divided into two groups. In Group 1 (178 knees), cefuroxime-impregnated
cement was used for fixation, whereas in Group 2 (162 knees), the
cement did not contain cefuroxime. There was no significant difference
between the two groups regarding demographic variables, the preoperative
or postoperative knee score, the duration of the operation or of
the use of the tourniquet, or the amount of blood transfused perioperatively.
The average duration of follow-up was forty-nine months (range,
twenty-six to eighty months).
No deep infection developed in the 178 knees in Group 1, whereas
a deep infection developed in five (3.1%) of the 162 knees in Group
2 (p = 0.0238). Two superficial wound infections developed in each
Cefuroxime-impregnated cement was shown to be effective in the
prevention of early to intermediate deep infection after primary
total knee arthroplasty performed with use of perioperative systemic
antibiotic prophylaxis but no so-called clean-air measures.