Antibiotic Containing Bone Substitute in Major Hip Surgery: A Long Term Gentamicin Elution Study

Journal of Bone and Joint Infection
M StravinskasLars Lidgren

Abstract

Objectives: The objective is to present the antibiotic elution from a locally implanted gentamicin containing hydroxyapatite and calcium sulphate bone substitute with an extended follow up of 30 days. We also compare the pharmacokinetics of the ceramic bone substitute with a published study on gentamicin containing poly (methyl methacrylate) (PMMA) bone cement used in primary total hip arthroplasty. Methods: Gentamicin release was measured in the urine for a month and the serum for 4 days in 10 patients operated for trochanteric hip fractures and 10 patients in uncemented hip revisions. 17 patients were followed up at one year and 3 patients at 6 months. Results and Discussion: The gentamicin concentrations measured in serum were low and approximately 100 times less than in urine during the first days, indicating high local concentrations at the implant site. The elution from the biphasic bone substitute showed a stronger burst and higher gentamicin concentrations for the first week compared to that reported for PMMA used in hip arthroplasty. Also, for the bone substitute a complete gentamicin elution was obtained after 30 days, while for the PMMA cement sub-inhibitory MIC levels of gentamicin were still present in urine 60 day...Continue Reading

References

Jun 1, 1992·Acta Orthopaedica Scandinavica·M OgaY Sugioka
Feb 1, 1980·Acta Orthopaedica Scandinavica·H Wahlig, E Dingeldein
Nov 12, 2009·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·Antonio AbramoMagnus Tägil
Sep 28, 2015·The Orthopedic Clinics of North America·Jourdan M CancienneSeth R Yarboro

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Citations

Apr 17, 2019·Journal of Biomaterials Applications·Rema A OliverWilliam R Walsh
Mar 28, 2019·Bone & Joint Research·M StravinskasL Lidgren
Aug 28, 2020·Therapeutics and Clinical Risk Management·Holger FreischmidtThorsten Guehring

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