Antibiotic-Loaded Acrylic Cement (ALAC)
Since the use of antibiotic-loaded acrylic cement (ALAC) was first suggested by Buchholz and Engelbrecht (1970) as a prophylactic measure against infection following joint replacement operations, there has been a remarkable difference in the degree of its acceptance among European and North American surgeons. This was due to the justifiable caution of American colleagues with respect to potential complications (mechanical, allergic, toxic, and antimicrobial resistance). All these risks have been cited in early investigations and all would expose the surgeons using the material casually to serious criticism, if not litigation. However, as the years have gone by, such potential hazards have apparently not occurred. Frankly, I believe that many patients have been unnecessarily deprived of its use and subjected to old-fashioned operations such as resection arthroplasties or multiple-staged revision procedures; unnecessary infections may have followed joint replacements in a previously operated or infected field.
KeywordsFatigue Microbe Gentamicin Polymethylmethacrylate Palacos
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