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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e19-e24 |
| Journal | Orthopedics |
| Volume | 36 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2013 |
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All Science Journal Classification (ASJC) codes
- Surgery
- Orthopedics and Sports Medicine
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Articulating spacers for the treatment of infected total knee arthroplasty : Effect of antibiotic combinations and concentrations. / Nettrour, John F.; Polikandriotis, John A.; Bernasek, Thomas L.; Gustke, Kenneth A.; Lyons, Steven T.
In: Orthopedics, Vol. 36, No. 1, 01.01.2013, p. e19-e24.Research output: Contribution to journal › Article
TY - JOUR
T1 - Articulating spacers for the treatment of infected total knee arthroplasty
T2 - Effect of antibiotic combinations and concentrations
AU - Nettrour, John F.
AU - Polikandriotis, John A.
AU - Bernasek, Thomas L.
AU - Gustke, Kenneth A.
AU - Lyons, Steven T.
PY - 2013/1/1
Y1 - 2013/1/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84873824551&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84873824551&partnerID=8YFLogxK
U2 - 10.3928/01477447-20121217-13
DO - 10.3928/01477447-20121217-13
M3 - Article
C2 - 23276347
AN - SCOPUS:84873824551
VL - 36
SP - e19-e24
JO - Orthopedics
JF - Orthopedics
SN - 0147-7447
IS - 1
ER -