Measurements of in vivo intra-articular gentamicin levels from antibiotic loaded articulating spacers in revision total knee replacement

Mutimer, J; Gillespie, G; Lovering, Andrew; Porteous, A

doi:10.1016/j.knee.2008.07.009

Cited by 33 publications

(23 citation statements)

References 9 publications

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“…Highest measured concentrations were 50.93 µg/g for gentamicin, 177.24 µg/g for vancomycin, and 322.29 µg/g for clindamycin. Similar values for gentamicin have been determined in the study of Mutimer et al 14.…”

Section: Pharmacokinetic Propertiessupporting

confidence: 85%

Therapeutic Use of Antibiotic-loaded Bone Cement in the Treatment of Hip and Knee Joint Infections

Anagnostakos

2017

J. Bone Joint Infect.

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The use of antibiotic-loaded cement spacers is an established method in the management of periprosthetic hip and knee joint infections. Despite inconsistencies among published studies, data shows that infection control rates exceed 90% with two-stage exchange arthroplasty. The present work reviews the current literature about antibiotic-loaded cement spacers and concentrates on the indications for spacer implantation, spacer production details, antibiotic impregnation, pharmacokinetic properties, clinical success, mechanical complications, and systemic safety.

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Section: Pharmacokinetic Propertiessupporting

confidence: 85%

Therapeutic Use of Antibiotic-loaded Bone Cement in the Treatment of Hip and Knee Joint Infections

Anagnostakos

2017

J. Bone Joint Infect.

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“…It allows for a more predictable level of antibiotic elution, as was recently demonstrated by Mutimer et al 18 in a series of infected total knee arthroplasties. The spacer used in their study is made by the same company and has identical consistency as the one used in this study.…”

Section: Discussionmentioning

confidence: 81%

“…They demonstrated therapeutic intra-articular gentamicin levels at a median 99 days after spacer placement. 18 Although the spacer achieves therapeutic intra-articular antibiotic concentrations, serum levels have also been detected; however, these levels have been demonstrated to be low. 18 There are several reports of acute renal failure after placement of cement spacers containing gentamicin and tobramycin, so caution should be exercised in patients with poor renal function.…”

Section: Discussionmentioning

confidence: 99%

“…18 Although the spacer achieves therapeutic intra-articular antibiotic concentrations, serum levels have also been detected; however, these levels have been demonstrated to be low. 18 There are several reports of acute renal failure after placement of cement spacers containing gentamicin and tobramycin, so caution should be exercised in patients with poor renal function. 6,8,19,25 We added a collar of vancomycin-impregnated polymethylmethacrylate cement at the time of spacer placement.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of glenohumeral sepsis with a commercially produced antibiotic-impregnated cement spacer

Coffey

Ely

Crosby

2010

Journal of Shoulder and Elbow Surgery

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“…Seven studies reported on the release of antibiotics after spacer implantation [6–8, 11–13, 16], three studies at spacer removal [9, 14, 15], and one study on both time points [10]. Seven studies reported on hip spacers [6, 9–13, 16], one study on knee spacers [15], and three studies on both [7, 8, 14] (Table 1). In eight studies, custom-made spacers have been implanted and in three prefabricated ones.…”

Section: Resultsmentioning

confidence: 99%

Antibiotic Elution from Hip and Knee Acrylic Bone Cement Spacers: A Systematic Review

Anagnostakos

Meyer

2017

BioMed Research International

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Knowledge about the elution from antibiotic-loaded cement spacers is an indispensable premise for guarantee of clinical success. A systematic literature search was performed through PubMed. Search terms were “antibiotic elution” and “antibiotic release” in combination with “spacer,” “hip spacer,” and “knee spacer,” respectively. A total of 11 studies could be identified. Seven studies reported on the release of antibiotics after spacer implantation, three studies at spacer removal, and one study on both time points. Seven studies reported on hip spacers, one study on knee spacers, and three studies on both. In eight studies, custom-made spacers have been implanted and in three prefabricated ones. In the majority of the studies, the cement has been loaded with an antibiotic combination, mostly consisting of aminoglycoside (either gentamicin or tobramycin) and vancomycin. Measured concentrations exceeded the minimal inhibitory concentration of the particular pathogen organisms in each case. However, large discrepancies were observed with regard to the height of the antibiotic concentration depending on the antibiotic combination and the antibiotic ratio used. Current literature data indicate a sufficient elution of antibiotics after spacer implantation and at spacer removal, respectively. Future studies are required to optimize the local antibiotic therapy at the site of spacer implantation.

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Measurements of in vivo intra-articular gentamicin levels from antibiotic loaded articulating spacers in revision total knee replacement

Cited by 33 publications

References 9 publications

Therapeutic Use of Antibiotic-loaded Bone Cement in the Treatment of Hip and Knee Joint Infections

Therapeutic Use of Antibiotic-loaded Bone Cement in the Treatment of Hip and Knee Joint Infections

Treatment of glenohumeral sepsis with a commercially produced antibiotic-impregnated cement spacer

Antibiotic Elution from Hip and Knee Acrylic Bone Cement Spacers: A Systematic Review

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