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

Table 3

Findings about the antibiotic elution from hip and knee spacers at spacer removal.

Study	Place of; measurement	Length of spacer implantation	Pharmacokinetic findings	Infection control
Fink et al. [9]	Local tissue	Six weeks	50.93 µg/g, 177.24 µg/g, 322.29 µg/g; No differences in [G] and [C] regardless of whether V has been added to cement; No differences between levels associated with acetabular cup and those with spacer stem	n.r.
Hsieh et al. [10]	Joint fluid	Mean 107 days	All [V] and [A] above the MIC despite an apparent trend toward decreasing levels over time	97.8%
Masri et al. [14]	Joint fluid	Mean 118 days	No significant differences between hip and knee spacers; Highest [T] and [V] when at least 3.6 g T was impregnated; Significant increase when the dose of T was increased from at most 2.4 g to at least 3.6 g per cement package; V has no significant influence on [T]; Increase of the V dose from 1 to 1.5–2 g V per cement package with no significant influence on [T] or [V]; Apparent trend toward decreasing levels over time	n.r.
Mutimer et al. [15]	Joint fluid	Median 99 days	Median [G] 0.46  µg/ml	100%

G: gentamicin; V: vancomycin; C: clindamycin; A: aztreonam; T: tobramycin; MAX: maximum; MIN: minimum; MIC: minimal inhibitory concentration; n.r.: not reported.