Gentamicin-impregnated cement beads and spacers are frequently used in case of infective complications after Total Knee Arthroplasty (TKA). A great number of studies in the literature demonstrated that the local administration of gentamicin produces high local antibiotic levels but low serum and urine gentamicin concentrations. Gentamicin-impregnated cement spacer can induce nephrotoxicity in patients presenting major renal impairment susceptibility. We report a case of acute renal failure using a gentamicin-impregnated block spacer. An 83-year-old woman underwent a gentamicinimpregnated bone-cement spacer implant because of an infected TKA removal. Three days later patient clinical status got worse reporting a decreased urine output and increasing C-reactive protein (CRP), Serum Creatinine (SCr) and Blood Urea Nitrogen (BUN). Because the symptoms could be related to the knee spacer lead us to the decision of gentamicin-impregnated cement spacer removal. The day following the removal procedure showed progressive improvement of general condition with evidence of SCr and BUN normalization. Gentamicin-impregnated cement spacer can induce nephrotoxicity in patients presenting major renal impairment susceptibility.
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http://dx.doi.org/10.4081/or.2020.8540 | DOI Listing |
Cureus
December 2024
Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, JPN.
Background: Two-stage revision is known as the gold-standard method for knee prosthetic joint infection (PJI), but the most suitable treatment method remains controversial. Typically, weight-bearing is restricted during the interval between the stages. The aim of this study was to evaluate the clinical outcomes of unrestricted weight bearing with cement spacers fabricated using the Knee Articulating Spacer Mold (KASM®; Ortho Development Corporation, Draper, UT, USA) for knee PJI.
View Article and Find Full Text PDFArthroplasty
January 2025
Department of Orthopedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
Purpose: The study aimed to compare the infection control rates, mechanical complications, and functional outcomes between prosthetic and cement spacers in two-stage revision arthroplasty for chronic periprosthetic joint infection (PJI).
Patients And Methods: Data from patients treated for chronic PJI in our center from 2014 to 2023 were retrospectively collected and the patients were divided into the prosthetic spacer (PS) and cement spacer (CS) groups based on the type of spacer used for the first-stage surgeries. Data on patients' demographics and clinical scores were harvested.
Antibiotics (Basel)
December 2024
Division of Orthopedic Surgery, Rambam Health Care Campus, Haifa 3109601, Israel.
Introduction: Despite the rising global awareness and improvement of socioeconomic and living standards, the prevalence of diabetic osteomyelitis (DOM) and its complications has been increasing rapidly. This study aims to investigate the long-term prognosis of DOM of the foot treated using antibiotic-impregnated cement spacer (ACS) and the contributing risk factors for reoperation.
Methods And Materials: We retrospectively reviewed the data of 55 diabetic patients with Meggitt-Wagner Grade IIB wounds diagnosed with osteomyelitis of the foot, treated in our institution with excessive debridement, excision of the infected tissue, and implantation of antibiotic-impregnated cement spacer fixed with a Kirschner wire.
Dent J (Basel)
November 2024
Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA.
Occlusion plays a crucial role in the long-term success and functionality of dental restorations. The purpose of this study was to investigate the changes in occlusal contacts upon the cementation of zirconia crowns with different cement spacer settings in computer-aided design and computer-aided manufacturing (CAD-CAM) software (3Shape Dental System version 2.102.
View Article and Find Full Text PDFJ Clin Orthop Trauma
January 2025
Department of Orthopaedics, Rehman Medical Institute, 5/B-2, Phase 5 Hayatabad, Peshawar, Pakistan.
Background: The shoulder girdle and proximal humerus are common sites for neoplastic lesions be it benign or malignant. We aimed to evaluate the outcomes of a frugal method of reconstruction of the proximal humerus for neoplastic lesions at short to medium term follow-up.
Methods: Data for this retrospective case series was collected from an electronic data base held at the primary authors institution.
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