Antibiotic-Loaded Acrylic Bone Cement in the Revision of Septic Arthroplasty: Where’s the Evidence?

Patti, Brianna N.; Lindeque, Bennie

doi:10.3928/01477447-20110124-22

Cited by 6 publications

(2 citation statements)

References 88 publications

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“…However, despite the fact that the high local concentration of antibiotic can be relatively short lived, eluting cements may reduce the risk of the establishment of a chronic infection in the initial postsurgical period by killing planktonic cells before they can establish a biofilm. Clinical evidence pointing to the optimal parameters required for infection control are difficult to interpret due to the variability in brand of cement, concentration and type of antibiotics, mixing techniques, anatomical location and shape and size parameters of the formed cement; however, the general consensus is that antibiotic-loaded acrylic cement is useful in the treatment and management of chronic orthopedic infections [126,127]. More recently, bioabsorbable materials such as calcium sulfate and calcium phosphate have regained the interest of researchers and clinicians.…”

Section: Future Directions In the Prevention And Treatment Of Biofilms mentioning

confidence: 99%

Biofilms in Periprosthetic Orthopedic Infections

et al. 2014

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As the number of total joint arthroplasty and internal fixation procedures continues to rise, the threat of infection following surgery has significant clinical implications. These infections may have highly morbid consequences to patients, who often endure additional surgeries and lengthy exposures to systemic antibiotics, neither of which are guaranteed to resolve the infection. Of particular concern is the threat of bacterial biofilm development, since biofilm-mediated infections are difficult to diagnose and effective treatments are lacking. Developing therapeutic strategies have targeted mechanisms of biofilm formation and the means by which these bacteria communicate with each other to take on specialized roles such as persister cells within the biofilm. In addition, prevention of infection through novel coatings for prostheses and the local delivery of high concentrations of antibiotics by absorbable carriers has shown promise in laboratory and animal studies. Biofilm development, especially in an arthoplasty environment, and future diagnostic and treatment options are discussed.

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Section: Future Directions In the Prevention And Treatment Of Biofilms mentioning

confidence: 99%

Biofilms in Periprosthetic Orthopedic Infections

et al. 2014

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“…Regardless of whether elution rates follow a bi-or tri-phasic pattern, it seems generally well accepted that the initial exponential phase is short-lived and likely drops off rapidly. 6,8,14,18 However, there are others that have shown that antibiotic release can occur even up to 4 months postimplantation. 15,16 One of the more important issues of using high-dose ALBC, however, is the potential risk of systemic toxicity.…”

Section: Discussionmentioning

confidence: 99%

Acute renal failure after high-dose antibiotic bone cement: case report and review of the literature

James

Larson

2015

Renal Failure

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High-dose antibiotic-loaded bone cement (ALBC) spacers are commonly used to treat prosthetic joint infections following total hip and knee arthroplasties. This methodology can provide high local antibiotic concentrations while minimizing systemic exposure and toxicity. The occurrence of acute kidney injury (AKI) is rarely reported. Available literature suggests that the rate may be higher than previously thought. We report a case of significant systemic tobramycin absorption with concomitant acute renal failure in a 69-year-old female following the implantation of a high-dose ALBC spacer containing both tobramycin and vancomycin. The tobramycin level 24 h post-surgery was 5.8 mcg/mL. Due to concomitant renal failure, antibiotic clearance was poor and resulted in prolonged exposure to elevated aminoglycoside levels. Recovery of renal function occurred, but clinicians should be vigilant in considering the potential impact ALBC spacers can have on post-operative renal function if antibiotic elution is higher than expected.

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