[Elimination of antibiotics from Palacos bone cement (personal experience from a bacteriological viewpoint after 10-year application in joint replacement surgery].

Long-term studies were set up to investigate the release of various antibiotics from bone cement. In some cases release was evidenced for a few days, in others for many months or years. All alloarthroplastic operations are threatened by infection. We therefore advocate the prophylactic use of antibiotics in any case of major corrective joint replacement surgery, and our method has been valuable in many patients. Deep infection from resistant bacteria and mixed infection require a combination of two or more appropriate antibiotics. The antibiotic effect evidenced in vitro cannot simply be transferred to the mechanism of elution of antibiotics out of cement. Examples are given. Bacteriological studies and clinical investigations are a prelude to prophylactic treatment with single antibiotics and in combination. A great number of able bacteriologists and clinicians is required in attempts to tackle this vast and difficult therapeutical problem.