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

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          Abstract

          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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          Antibiotic-impregnated cement spacers for the treatment of infection associated with total hip or knee arthroplasty.

          Khaled J. Saleh, Michael E. Ries, Laura S Shields … (2007)
          Article 0 comments Cited 56 times – based on 0 reviews     Review now
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            Systemic safety of high-dose antibiotic-loaded cement spacers after resection of an infected total knee arthroplasty.

            Gwo-Bin Lee, Arlen D. Hanssen, Judy B. Springer … (2004)
            The purpose of this study was to assess the systemic safety and potential adverse effects of using a high-dose antibiotic-impregnated cement spacer after resection arthroplasty of an infected total knee replacement. Between October 2000 and December 2002, 36 knees (34 patients) had a resection arthroplasty of an infected total knee prosthesis with placement of a high-dose antibiotic impregnated cement spacer. There were 24 men and 10 women with a mean age of 66.5 years (range, 48-84 years). All spacers placed contained an average of 3.4 batches of cement with an average total dose of 10.5 g of vancomycin (range, 3-16 g) and 12.5 g of gentamicin (range, 3.6-19.2 g). All patients were followed up post-operatively until reimplantation for evidence of renal failure. The preoperative creatinine ranged from 0.7 to 1.8 mg/dL. All patients were concomitantly treated with 6 weeks of intravenous organism-specific antibiotics. One patient with normal preoperative renal function (Cr 0.7 mg/dL) had a perioperative 1-day transient rise in serum creatinine (1.7 mg/dL) postoperatively that subsequently normalized. No patients showed any clinical evidence of acute renal insufficiency, failure, or other systemic side effects of the antibiotics. Treatment of patients with an infected total knee arthroplasty with high-dose vancomycin and gentamicin antibiotic spacers seems to be clinically safe.
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              Antibiotic-impregnated PMMA hip spacers: Current status.

              Jens Kelm, Konstantinos Anagnostakos, Oliver Fürst (2006)
              The infection rate after primary hip arthroplasty lies at 1-2%. In the past few years, a two-stage protocol with the implantation of an antibiotic-loaded spacer has become a popular procedure in the treatment of infected hip joint arthroplasties. In this review, we pay special attention to the elution characteristics of the spacers, their mechanical stability and the clinical response. We conclude that hip spacers are an effective method in the treatment of hip joint infections, with success rates of over 90%.
              Article 0 comments Cited 51 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Bone Jt Infect
                Journal ID (iso-abbrev): J Bone Jt Infect
                Journal ID (publisher-id): jbji
                Title: Journal of Bone and Joint Infection
                Publisher: Ivyspring International Publisher (Sydney )
                ISSN (Electronic): 2206-3552
                Publication date Collection: 2017
                Publication date (Electronic): 1 January 2017
                Volume: 2
                Issue: 1
                Pages: 29-37
                Affiliations
                Zentrum für Orthopädie und Unfallchirurgie, Klinikum Saarbrücken, Saarbrücken, Germany.
                Author notes
                ✉ Corresponding author: PD Dr. Konstantinos Anagnostakos, Zentrum für Orthopädie und Unfallchirurgie, Klinikum Saarbrücken, Winterberg 1, D-66119, Saarbrücken, Germany. Tel.: 0049-681-9632896 Fax: 0049-681-9632515 Mail: k.anagnostakos@ 123456web.de .

                Competing Interests: The author has declared that no competing interest exists.

                Article
                Publisher ID: jbjiv02p0029
                DOI: 10.7150/jbji.16067
                PMC ID: 5423576
                PubMed ID: 28529862
                SO-VID: 62091ac5-27f8-4ad5-886b-c1b399503f02
                Copyright © © Ivyspring International Publisher
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license ( https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.

                History
                Categories
                Subject: Review

                Keywords: hip spacer,knee spacer,hip infection,knee infection,antibiotic-loaded bone cement.
                Data availability:
                Keywords: hip spacer, knee spacer, hip infection, knee infection, antibiotic-loaded bone cement.

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