Sometimes after surgery to repair an injured bone or joint, infection can cause the bone to heal improperly. Surgeons use calcium sulfate to prevent infections in joints after surgery. Calcium sulfate can be impregnated with antibiotics and placed inside the joint, where the bloodstream often cannot deliver intravenous or oral antibiotics effectively. We reviewed 20 years of studies of the effectiveness of calcium sulfate and found high rates of healing and infection eradication.

A simulated large joint model has been established to help better understand the elution mechanics of antimicrobial agents and the devices used to deliver them to a large human joint. This model is unique to previously published models in that it more accurately represents the environment of a large human joint. The model was employed to evaluate four brands of commercial medical-grade calcium sulfate. These products were evaluated in both an unaltered state and when mixed with antibiotics.

Irrigation and debridement in the treatment of periprosthetic joint infection (PJI) serves an integral role in the eradication of bacterial burden and subsequent re-infection rates. Identifying the optimal irrigation agent, however, remains challenging, as there is limited data on superiority. Future clinical studies are needed to identify ideal irrigation solutions with optimal bactericidal properties and low cytotoxicity for PJI treatment.

Antibiotics are frequently used in bone cement during joint replacements or treatment of bone and joint infections. Amikacin is rarely used in bone cement, particularly the liquid formulation. We describe a series of patients in which liquid amikacin was incorporated into bone cement. We did not observe the occurrence of adverse drug reactions definitively attributed to its use. All patients had favorable outcomes.