Faculty Collaboration Database

Articulating spacers for the treatment of infected total knee arthroplasty: effect of antibiotic combinations and concentrations. Orthopedics 2013 Jan;36(1):e19-24

Date

01/02/2013

Pubmed ID

23276347

DOI

10.3928/01477447-20121217-13

Scopus ID

2-s2.0-84873824551 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

Performing 2-stage procedures using articulating antibiotic cement spacers to eradicate infection while providing pain relief and maintaining function has become common among many surgeons. Despite the efficacy of antibiotic cement spacers in the treatment of infected total knee arthroplasty, questions remain regarding the dosing of the antibiotic cement. The authors assessed their experience with different antibiotic regimens and concentrations for the eradication of infection. Sixty-nine infected total knee arthroplasties with an average follow up of 31 months (range, 6-70 months) treated with articulating antibiotic spacers were retrospectively reviewed. Treatment groups were divided according to spacer antibiotic agents used and the amount of antibiotics added to the cement. Low-dose spacers were defined as those incorporating less than 4 g of antibiotic per 40-g bag of cement, and high-dose spacers were defined as those incorporating 4 g or more of antibiotic per 40-g bag of cement. High- vs low-dose spacers using a single or multiple antibiotic agents were compared. The overall rate of infection eradication was 88%. Dose dependency was not detected for spacers that incorporated single or multiple antibiotic agents, and multiple-agent spacers produced comparable success rates despite more frequent use in patients with impaired immune function. Further study of optimal combinations and concentrations of antibiotic agents incorporated into these spacers is needed to help minimize treatment failures while maximizing treatment efficacy.

Author List

Nettrour JF, Polikandriotis JA, Bernasek TL, Gustke KA, Lyons ST

Author

John Fairbanks Nettrour MD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Anti-Bacterial Agents
Arthroplasty, Replacement, Knee
Female
Humans
Male
Middle Aged
Retrospective Studies
Surgical Wound Infection
Tobramycin
Treatment Failure
Vancomycin