Authors: Bryan Springer, M.D.: David J. Jacofsky, M.D.; Gwo-Chin Lee, M.D.; Doug Osmon, M.D.; George Haidukewych, M.D.; Arlen Hanssen, M.D
Title: Systemic Safety of High Dose Antibiotic Cement Spacers Following Resection Arthroplasty of Infected Total Knee
Address: Mayo Clinic, 200 First Street SW, Rochester, MN 55905
Purpose: To assess the systemic safety and adverse effects of using a high dose antibiotic cement spacer following resection arthroplasty of an infected total knee replacement.
Methods: From October 2000 to December 2002, 34 knees (33 patients) underwent resection arthroplasty of infected total knee prosthesis with placement of a high dose antibiotic cement spacer by a single surgeon. There were 23 males and 10 females with an avenge age of 66.5 years. All spacers placed contained on average of 3.4 batches of cement containing a total dose of 10.5 g of Vancomycin (range 3 - 16g) and 12.5g of Gentamycin (range 3.6-19.2g). All patients were followed postoperatively until the time of re-implantation for evidence of renal failure. The preoperative creatinine ranged from 0.7-1.8 mg/dl. All patients were concomitantly treated with 6 weeks of intravenous antibiotics.
Results: Two patients with normal preoperative renal function had a perioperative one-day transient rise in serum creatinine postoperatively that subsequently normalized. No patients showed any clinical evidence of acute renal insufficiency / failure or other systemic side effects of the antibiotics.
Discussion and Significance: In this series, treatment with a high dose vancomycin and gentamycin antibiotic spacers appears to be clinically safe in treating patients with an infected total knee arthroplasty.