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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.

Musculoskeletal Infecton Society
Musculoskeletal Infecton Society
PO Box 714
Rochester, MN 55903