ArticleClinical orthopaedics and related research2015
Antimicrobial Release From Prefabricated Spacers Is Variable and the Dose Is Low.
Article in Clinical orthopaedics and related research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Antibiotic Elution from Hip and Knee Acrylic Bone Cement Spacers: A Systematic Review.BioMed research international · 2017Pooled it
- Double-Layered Antibiotic-Loaded Cement Spacer for Hip Infection: A Report of Two Cases.Journal of orthopaedic case reports · 2026Article
- Antibiotic Elution from Cement Spacers and Its Influencing Factors.Antibiotics (Basel, Switzerland) · 2025Review
- Mechanical complications and infection control comparison of custom-made and prefabricated articular hip spacers in the treatment of periprosthetic infection.Joint diseases and related surgery · 2023Article
- Articulating spacers: what are available and how to utilize them?Arthroplasty (London, England) · 2023Review
- Utilizing a Prefabricated Antibiotic-Impregnated Articular Spacer Combined With an Intramedullary Device for Significant Femoral Bone Loss in Periprosthetic Hip Infection.Arthroplasty today · 2022Article
- Review
- Combined antibiotic therapy spacers either commercial or handmade are superior to monotherapy - a microbiological analysis at the second stage of revision.Journal of bone and joint infection · 2021Article
- Trends in the treatment of infected knee arthroplasty.EFORT open reviews · 2020Review
- Antibiotics release from cement spacers used for two-stage treatment of implant-associated infections after total joint arthroplasty.Journal of biomedical materials research. Part B, Applied biomaterials · 2019Article
- Drug reaction with eosinophilia and systemic symptoms syndrome after total knee arthroplasty infection and placement of antibiotic spacer.Arthroplasty today · 2019Article
- Determination of Tobramycin and Vancomycin Exposure Required to Eradicate Biofilms on Muscle and Bone TissueJournal of bone and joint infection · 2019Article
- Drug reaction with eosinophilia and systemic symptoms (DRESS): an unusual manifestation of multi-visceral abnormalities and long-term outcome.Discoveries (Craiova, Romania)Article
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5 authors.
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Abstract
backgroundHigh-dose antimicrobial-loaded bone cement (ALBC) is recommended to treat orthopaedic infections. Elution characteristics from prefabricated ALBC spacers and how they compare with hand-mixed ALBC are not well described. QUESTIONS/PURPOSES: (1) How does antimicrobial release from prefabricated spacers compare with release from hand-mixed ALBC over time? (2) Is antimicrobial release uniform across the surface of prefabricated ALBC spacers? (3) Do variations exist between different prefabricated spacer components? (4) Do textured surfaces release more antimicrobial than smooth surfaces?
methodsSix prefabricated ALBC spacer components, two hip and four knee, and three hand-mixed ALBC formulations were studied in this comparative laboratory study. Gentamicin was eluted from 41 discrete sites over the surfaces of six spacer components and compared with elution from 15 ALBC specimens, five from each of three hand-mixed formulations. Elution was compared between spacer sites, components, and surface texture. Statistical analysis was performed by analysis of variance and Tukey's multiple-comparison test or t-test.
resultsGentamicin release was highest in the first 24 hours for both prefabricated ALBC spacers and hand-mixed ALBC. Elution decreased over 7 days similarly for both. At Day 7, prefabricated ALBC spacers eluted more than hand-mixed 1 g ALBC (1 g ALBC: 1.49 ± 0.34, prefabricated: 3.59 ± 1.48, mean difference = 2.1 [0.2-4.0], p = 0.04) but eluted less than 5 g ALBC (9.21 ± 1.31, mean difference = -5.6 [-3.5 to -7.7], p < 0.001) and less than 10 g ALBC (35.8 ± 1.69, mean difference = -32.2 [-29.8 to -34.6], p < 0.001). Release varied from 2.7 to 9.9 µg/mm(2) over the surface of the spacers and from 3.5 to 5.5 µg/mm(2) between components with no component different than the others (Tukey). Release from textured surfaces was inconsistent.
conclusionsAntimicrobial release from prefabricated ALBC spacers is consistent with low-dose ALBC. Variation across the surface and between components is small compared with changes in antimicrobial load. CLINICAL RELEVANCE: Antimicrobial release from prefabricated ALBC spacers is consistent with local antimicrobial delivered from other low-dose ALBC formulations.
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