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Aseptic Revision in Arthroplasty

Revision procedures are mainly classified as aseptic, but in around 10% of the cases this is a false-negative diagnosis, and the loosening is caused by a periprosthetic joint infection (PJI).1

Drawn legs with knee prosthesis with red area around symbolizing pain

Given the higher likelihood of infection in revision arthroplasty and the catastrophic consequences of its occurrence2,3, the dual antibiotic-loaded bone cement COPAL® G+C supports the objective of more effective infection prevention.4

COPAL® G+C

High-viscosity bone cement with gentamicin and clindamycin

Learn more about COPAL G+C
Image of COPAL G+C bone cement package
Bone Cement

Supporting Study Results

57% Reduction of Infection in Aseptic Knee Revision Arthroplasty

A retrospective study by Pablo Sanz-Ruiz reported that the use of dual antibiotic-loaded bone cement (DALBC) in aseptic revision total knee arthroplasty was associated with a significant reduction in PJI cases.

A PJI rate of 4.1% was found in the single antibiotic-loaded bone cement (SALBC) group (PALACOS® R+G) vs 0% in the COPAL® G+C group (p = 0.035). The relative risk reduction was 57%, the calculated total saving per patient was $1367.5

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Study Summary - Sanz-Ruiz et al. (2020): Is Dual Antibiotic-Loaded Bone Cement More Effective and Cost-Efficient Than a Single Antibiotic-Loaded Bone Cement to Reduce the Risk of Prosthetic Joint Infection in Aseptic Revision Knee Arthroplasty?

Consider Aseptic Revision Cases as Possible Septic Ones

Aseptic revision carries the possibility of a low-grade infection. Jacobs et al. with their study showed that up to 12% of all perceived aseptic knee and hip revisions showed positive cultures.

By using a dual antibiotic-loaded bone cement greater local antibiotic efficiency can be achieved – especially in revision procedures that in general have a higher risk of infection.6 

Find out more about why it makes sense to consider aseptic cases as possible septic ones in the lecture of Jon H. M. Goosen, M.D.7

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Lecture summary - Goosen (2020): Septic or A-septic? Clinical relevance of unexpected PJI in presumed aseptic revision surgery