Gentamicin release from old cement during revision hip arthroplasty.
Bone cement containing gentamicin may release antibiotic when fractured during revision operations. Tissue samples taken during surgery may be contaminated by gentamicin and give inaccurate microbiological assessment. We studied five patients in whom cement containing gentamicin had been used in the primary procedure. During revision hip replacement, samples of joint fluid, tissues and cement were taken both before and after disruption of the cement. With the exception of one sample of joint fluid, low concentrations of gentamicin were recorded in the samples taken before the cement was disrupted, but after disruption the specimens contained gentamicin at concentrations high enough to inhibit or prevent growth of sensitive organisms. The cement contained very high levels up to ten years after insertion. Our findings suggest that no reliance can be placed on the microbiological assessment of specimens taken once cement splitting has started and that specimens should therefore be taken as early as possible.
Avon Orthopaedic Centre, Southmead Hospital, Westbury on Trym, Bristol, UK.
J W
JW
Powles
R F
RF
Spencer
A M
AM
Lovering
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000032:analysis / Q000737:chemistry*; D019644:Arthroplasty, Replacement, Hip; D001843:Bone Cements / Q000032:analysis / Q000737:chemistry*; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage / Q000032:analysis / Q000737:chemistry*; D006099:Granuloma / Q000378:metabolism; D006801:Humans; D017746:Joint Capsule / Q000378:metabolism; D007592:Joint Diseases / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D015203:Reproducibility of Results; D013210:Staphylococcus / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification; D013499:Surface Properties; D013582:Synovial Fluid / Q000737:chemistry; D013583:Synovial Membrane / Q000378:metabolism
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D005839:Gentamicins