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Related Experiment Videos

Systemic and local silver accumulation after total hip replacement using silver-impregnated bone cement

E Sudmann1, H Vik, M Rait

  • 1Hagavik Orthopaedic Hospital, Bergen, Norway.

Medical Progress Through Technology
|January 1, 1994
PubMed
Summary

Silver-impregnated bone cement used for infection prophylaxis in hip arthroplasty led to high local silver concentrations and neurological deficits. Removal of the cement and prosthesis resulted in decreased silver levels and partial neurological recovery.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Toxicology

Background:

  • Silver-impregnated bone cement is utilized for deep infection prophylaxis in total hip arthroplasty.
  • Revisional hip arthroplasty was performed on a patient who had previously received this type of cement.

Observation:

  • The patient developed severe neurological deficits five years post-implantation, with a loose prosthesis.
  • Intraoperative assessment revealed extremely high local silver concentrations in the hip joint fluid and acetabular tissue.

Findings:

  • Removal of the silver-impregnated cement and loose prosthesis led to a significant decrease in serum silver levels over two years.
  • Concurrently, the patient experienced partial recovery from severe muscle paralysis.

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Implications:

  • This case highlights a potential risk of systemic silver toxicity from silver-impregnated bone cement, manifesting as neurological deficits.
  • Careful monitoring and consideration of long-term silver elution are crucial when using such materials in orthopedic surgery.