Iciar M. Dávila  Castrodad,Joseph O.  Ehiorobo,Ethan  A. Remily,James  Nace,Nequesha  S. Mohamed,Nicole E.  George,Ronald Delanois,Wayne A. Wilkie,
Total Knee Arthroplasty: The Efficacy of Calcium Sulfate Beads in One-Stage Aseptic Revision
Journal of Surgery and Rehabilitation
2019
2733-2551
http://dx.doi.org/10.31487/j.JSR.2019.01.05
https://www.sciencerepository.org/total-knee-arthroplasty-the-efficacy-of-calcium-sulfate-beads-in-one-Stage-aseptic-revision_JSR-2019-1-105 
Abstract: Background: The risk of periprosthetic joint infection following revision total knee arthroplasty is high, as
is the cost of care. Decreasing periprosthetic joint infection risk may include utilization of calcium sulfate
beads. Calcium sulfate beads have been gaining momentum in treating infected joints because of their
potential advantages, including antibiotic elution and dissolvability. However, literature documenting their
utilization in aseptic revision is sparse. This study compares: 1) infection rates; 2) length of stay; 3)
subsequent infection procedures; and 4) final surgical outcome between one-stage aseptic revision total knee
arthroplasty patients who received calcium sulfate beads and those who did not.
Methods: We performed a retrospective chart review to identify patients who underwent aseptic one-stage
revision total knee arthroplasty between January 2013 and December 2017. Outcomes collected included
postoperative infection rate, length of stay, subsequent irrigation and debridement, and final surgical
outcome, classified as a successful total knee arthroplasty reimplantation, a retained antibiotic spacer, or an
above knee amputation. Chi-square analysis was used to analyze all categorical variables, while Student’s
t-testing was used for continuous variables. A p-value of 0.5 was set as the threshold for statistical
significance.
Results: Calcium sulfate bead patients did not differ from non-calcium sulfate bead patients with regard to
the number of postoperative infections (p=0.103), lengths of stay (p=0.210), irrigation and debridement
procedures (p=0.063) and surgical outcome (p=0.085).
Conclusion: Patients who received calcium sulfate beads had analogous surgical outcomes and infection
rates to non-calcium sulfate bead patients. The use of calcium sulfate beads in aseptic one-stage revision
total knee arthroplasty may not be beneficial in preventing infection and reducing costs.
Keywords: Calcium sulfate beads, one-stage aseptic revision, outcomes, total knee arthroplasty