Impregnation of vancomycin, gentamicin, and cefotaxime in a cement spacer for two-stage cementless reconstruction in infected total hip arthroplasty.
Twenty-two patients with infected total hip arthroplasty were treated with 2-stage arthroplasty, using a cement spacer impregnated with a combination of 3 thermostable antibiotics (vancomycin, gentamicin, and cefotaxime). Initially, implants were removed, and a spacer was inserted. Six to 12 weeks later, the spacer was removed, and the patients underwent reconstruction using cementless components. The patients were followed for an average of 41 months. One patient had a recurrence of infection and was treated with resection arthroplasty. The remaining 21 patients (95%) had no evidence of infection at the final follow-up. We recommend using the combination of these 3 antibiotics in the cement spacer for 2-stage reconstruction in infected hip arthroplasty when the causative organism is not identified in the culture of preoperative aspiration.
Koo
K H
KH
Department of Orthopaedic Surgery and Cardiovascular Research Institute, Gyeong-Sang National University School of Medicine, Chinju, South Korea. khkoo@nongae.gsnu.ac.kr
Yang
J W
JW
Cho
S H
SH
Song
H R
HR
Park
H B
HB
Ha
Y C
YC
Chang
J D
JD
Kim
S Y
SY
Kim
Y H
YH
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D001843:Bone Cements; D002439:Cefotaxime / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016459:Prosthesis-Related Infections / Q000188:drug therapy*; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D005839:Gentamicins; D014640:Vancomycin; D002439:Cefotaxime