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Tobramycin-impregnated cement in total hip replacements.
1Orthopaedic Surgery, University of Washington, Seattle.
Orthopaedic Review
|May 1, 1992
Summary
Adding tobramycin powder to bone cement for hip replacement surgery resulted in high local antibiotic concentrations in wound fluid. This approach effectively delivered tobramycin to the surgical site without causing systemic toxicity or adverse reactions.
Area of Science:
- Orthopedic Surgery
- Pharmacology
- Biomaterials Science
Background:
- Bone cement, such as polymethylmethacrylate (PMMA), is widely used in hip replacement surgery.
- Antibiotic-loaded bone cement is a strategy to prevent surgical site infections.
- Tobramycin is an aminoglycoside antibiotic effective against Gram-negative bacteria.
Purpose of the Study:
- To investigate the clinical effect of adding tobramycin powder to PMMA for hip replacement.
- To measure tobramycin concentrations in serum and wound drainage fluid.
- To assess the safety and efficacy of antibiotic-impregnated bone cement.
Main Methods:
- Fifteen patients undergoing total hip replacement received PMMA with 1.2 g tobramycin powder per 40-g pack.
- Cemented femoral and cementless acetabular prostheses were used.
- Postoperative serum and wound drainage fluid tobramycin levels were measured.
Main Results:
- Serum tobramycin concentrations remained low postoperatively.
- Wound drainage fluid demonstrated highly effective, bactericidal concentrations of tobramycin.
- No adverse reactions or toxicity related to the tobramycin-impregnated bone cement were observed.
Conclusions:
- Adding tobramycin powder to PMMA bone cement achieves high local antibiotic concentrations at the surgical site.
- This method provides effective local antibiotic delivery for hip replacement surgery.
- Tobramycin-impregnated bone cement is safe and well-tolerated in this patient cohort.