Antibiotic Elution from Hip and Knee Acrylic Bone Cement Spacers: A Systematic Review

Table 2

Findings about the antibiotic elution from hip and knee spacers after spacer implantation in vivo.

Study	Place of measurement	Time period of measurement	Pharmacokinetic findings	Infection control
Anagnostakos et al. [6]	Joint fluid	First 7 postop. days	39 µg/ml, 72 µg/ml on day 1; 1.9 µg/ml, 6.6 µg/ml on day 7; Between days 5 and 7 intermittent increase in the elution of both antibiotics	n.r.
Balato et al. [7]	Joint fluid	First 48 postop. hours	53.9 µg/ml in the hip group, 44.1 µg/ml in the knee group; Mean [G] significantly higher in the hip than in the knee group ( µg/ml versus  µg/ml) one hour after implantation	100%
Bertazzoni Minelli et al. [8]	Joint fluid	First 24 postop. hours	88 µg/ml in the hip group, 110 µg/ml in the knee group; 28.8 µg/ml in the hip group, 158.9 µg/ml in the knee group	100%
Hsieh et al. [10]	Joint fluid	First 7 postop. days	Mean 1,538 µg/ml, mean 1,003.5 µg/ml on day 1; Mean 571.9 µg/ml, mean 313.6 µg/ml on day 7	97.8%
Hsieh et al. [11]	Joint fluid	First 7 postop. days	Mean 58.3 µg/ml, mean 485.5 µg/ml on day 1; Mean 14.6 µg/ml, mean 76.1 µg/ml on day 7	95.2%
Isiklar et al. [12]	Joint fluid	First 24 postop. hours	Mean [V] 57  µg/ml	100%
Kelm et al. [13]	Joint fluid	First 7 postop. days	Vancomycin quantitatively higher than gentamicin; extrapolated concentration-time curves showed power functions, so that subtherapeutic antibiotic levels can be expected for vancomycin on the 17th postop. day and for gentamicin on the 14th postop. day	n.r.
Regis et al. [16]	Joint fluid	First 24 postop. hours	[G] ranged between 15 and 90 µg/ml; [V] ranged between 13.8 and 40 µg/ml	n.r.

G: gentamicin; V: vancomycin; A: aztreonam; MAX: maximum; MIN: minimum; n.r.: not reported.