Prophylaxis With Systemic Antibiotics Versus Gentamicin Bone Cement in Total Hip Arthroplasty

Biofilm formation by bacteria isolated from retrieved failed prosthetic hip implants in an in vitro model of hip arthroplasty antibiotic prophylaxis

“…and P. acnes isolates, thereby preventing adherence of these bacteria to the newly implanted device and subsequent prosthetic joint infection. Our results support previous studies in animal models of primary arthroplasty which show that the prophylactic use of antibioticloaded bone cement protects against infection after intra-operative challenge with bacteria 22,23 and the results of randomized, controlled trials which have also shown that the use of antibiotic-loaded bone cements protect against deep infection. 24,25 In summary, the findings of our in vitro study suggest that a combination of gentamicin loading of bone cement and pre-and postoperative administration of cefuroxime should prevent implant infection during both primary hip arthrolasty and revision hip arthroplasty if overt infection is not present.…”

The role of small-colony variants in failure to diagnose and treat biofilm infections in orthopedics

“…The infection rate from joint replacements has dropped dramatically since the procedure was first performed in the late 1960s, but even so about 1% of all patients develop such an infection (Josefsson andKolmert 1993, Philips andCrane 2006). This percentage may seem small, but since these joint replacement operations are so common, it is a complication that affects a significant number of patients.…”

Antibiotic-impregnated xenografts in the treatment of chronic osteomyelitic cavities

“…After debridement, obliteration of the remaining cavity is achieved by different methods, such as using the surrounding soft tissues [2], calcium hydroxyapatite [15], bone cement [8,9,11,13], collagen sponge [10], plaster of Paris [2], lactic acid oligomer [18], or bone grafts, either autogenous [7] or heterogenous [14]. Although most of these techniques have been used in clinical practice to deliver antibiotics, they have some limitations mainly due to the need to re- move the vehicles.…”

“…In the present study, we did not use additional systemic antibiotics, and so we have clearly demonstrated the effectiveness of our delivery system. Josefsson et al had shown that local administration of antibiotics resulted in a significant decrease in the rate of infection compared with systemic administration in total hip arthroplasties [11].…”