Role of gentamicin-impregnated cement in total joint arthroplasty

Garvin-K-L. Salvati-E-A. Brause-B-D. Cornell University Medical College, New York, New York. Orthop-Clin-North-Am. 1988 Jul. 19(3). P 605-10. Palacos-Gentamicin (PG) was used in 130 joint arthroplasties at The Hospital for Special Surgery. At an average follow-up of 2.5 years (range, 2 to 5), the overall recurrence rate of infection was 3.8 per cent. Only one (2.0 per cent) infection occurred where the bacteria were sensitive to PG and there were no infections in the two-stage reimplantation group. There have been no adverse effects from the gentamicin and the inferior intrusion properties of the PG have not been reflected in the clinical or radiographic results. Author-abstract. fslmbcrlÂ Formation of a synovial-like membrane at the bone-cement interface. Its role in bone resorption and implant loosening after total hip replacement. Goldring-S-R. Jasty. Roelke-M-S. Rourke-C-M. Bringhurst-F-R. Harris-W-H. Arthritis-Rheum. 1986 Jul. 29(7). P 836-42. Histologic evaluation of tissue surrounding the loosened components after joint replacement reveals the presence of a synovial-like lining adjacent to the polymethyl methacrylate cement. The tissue is heavily infiltrated with particulate cement as well as polyethylene associated with a foreign body-type giant cell reaction. That this tissue response may be responsible for the bone lysis associated with loosening is suggested by the demonstration of high prostaglandin E2 levels and enhanced bone resorbing activity in the tissue culture medium of fragments from this membrane. Author-abstract.