Abstract:
BACKGROUND:In some countries, commercially available antibiotic powder-loaded acrylic bone cement is routinely used in joint replacement, while, in others, "off-label" formulations are used in selected procedures (where the antibiotic powder is blended manually with the powder of a plain cement in the operating room/theater by either the surgeon or approved personnel). In the latter situation, an arbitrary rather than a rational approach is used for deciding on the amount of the antibiotic that is blended with the cement powder (herein referred to as "the antibiotic powder loading"). METHODS AND RESULTS:The first objective of this study was to present two methods for estimating the optimum loading of gentamicin sulfate powder that may be blended manually with the powder of a commercially available acrylic bone cement, ABC (Wopt). The second objective was to define the challenges associated with each of these methods. The loading (W) was optimized with respect to two key properties of the cured cement that were obtained simultaneously, namely (1) fatigue life in phosphate-buffered saline solution (PBS) at 37 degrees C, and (2) the rate of elution of the gentamicin from the cement (E) in that medium. Three sets of specimens were used, containing 2.25, 4.25 and 11.50 wt/wt% of the gentamicin that was blended manually with the cement powder. The fatigue tests involved determining the number of cycles at which a specimen fractured (Nf) when subjected to fully-reversed tension-compression sinusoidal load, +/- 15 MPa at 2 Hz. E was determined from the concentration of gentamicin in the PBS solution when the specimen fractured, using fluorescence polarization immunoassay for the measurement. Consistent with a priori expectations, it was found that, with increase in W, Nf decreased while E increased. Two approaches for obtaining an estimate of Wopt are described, a mathematical method and an empirical one, that lead to Wopt values of 6.50 wt/wt% and 4.78 wt/wt%, respectively. Thus, this antibiotic loading ranges from about the same to about 92% greater than that in SmartSet GHV Gentamicin, which is a commercially available bone cement used clinically and which has the same composition as SmartSet HV except for the presence of gentamicin sulfate in its powder (blended in by the manufacturer). INTERPRETATION:We present and critically compare two rational methods of determining the optimum loading of an antibiotic powder in an acrylic bone cement, which should serve as a guide when using "off-label" antibiotic powder-loaded acrylic bone cements in cemented joint replacements.
journal_name
Acta Orthopjournal_title
Acta orthopaedicaauthors
Lewis G,Janna Sdoi
10.1080/17453670610012700subject
Has Abstractpub_date
2006-08-01 00:00:00pages
622-7issue
4eissn
1745-3674issn
1745-3682pii
752076617journal_volume
77pub_type
杂志文章abstract::Background and purpose - Radiostereometric analysis (RSA) is the gold standard to study micromotion of joint replacements. RSA requires the acquisition of additional radiographs increasing the radiation dose of patients included in RSA studies. It is important to keep this dose as low as possible. Effective radiation ...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2020.1767443
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Hip resurfacing arthroplasty is claimed to allow higher activity levels and to give better quality of life than total hip arthroplasty. In this literature review, we assessed the therapeutic value of hip resurfacing arthroplasty as measured by functional outcome. METHODS:An extensive literature ...
journal_title:Acta orthopaedica
pub_type: 杂志文章,评审
doi:10.3109/17453674.2010.501742
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Complications related to the fibula during distraction osteogenesis could cause malalignment. Most published studies have analyzed only migration of the fibula during lengthening, with few studies examining the effects of fibular complications. PATIENTS AND METHODS:We retrospectively reviewed 12...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2012.665328
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Internal fixation (IF) in femoral neck fractures has high reoperation rates and some predictors of failure are known, such as age, quality of reduction, and implant positioning. Finding new predictors of failure is an ongoing process, and in this study we evaluated the importance of low bone mine...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2013.875360
更新日期:2014-02-01 00:00:00
abstract::Background and purpose - Alternative bearing surfaces such as ceramics and highly crosslinked polyethylene (HXLPE) were developed in order to further improve implant performance of total hip arthroplasties (THAs). Whether these alternative bearing surfaces result in increased longevity is subject to debate. Patients a...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2017.1405669
更新日期:2018-04-01 00:00:00
abstract::Background and purpose - Survivorship of total hip arthroplasty (THA) with the ultra-high molecular weight polyethylene (UHMWPE) monoblock cup has been limited due to periprosthetic osteolysis and aseptic loosening, secondary to wear of the UHMWPE. In response, a vitamin E blended highly cross-linked polyethylene (HXL...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2020.1807220
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We previously evaluated a new uncemented femoral stem designed for elderly patients with a femoral neck fracture and found stable implant fixation and good clinical results up to 2 years postoperatively, despite substantial periprosthetic bone mineral loss. We now present the medium-term follow-u...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2014.931195
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Cyclooxigenase-2 (COX-2) inhibitors have been reported to delay fracture healing. To investigate the major inhibitory period of COX-2 inhibitors in fracture healing, we administrated etodolac, a COX-2-specific inhibitor, to a rat fracture model by altering the period of administration from early to late. ME...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670510041439
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The osteogenic potency of erythropoietin (EPO) has been documented. However, its efficacy in a large-animal model has not yet been investigated; nor has a clinically safe dosage. The purpose of this study was to overcome such limitations of previous studies and thereby pave the way for possible c...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2014.889981
更新日期:2014-04-01 00:00:00
abstract::Background and purpose - The treatment of patients between 55 and 70 years with displaced intracapsular femoral neck fracture remains controversial. We compared internal fixation (IF), bipolar hemiarthroplasty (HA) and total hip arthroplasty (THA) in terms of mortality, reoperations and patient-reported outcome by usi...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2017.1376514
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Extracorporeal shock wave treatment has been used successfully for the treatment of avascular necrosis of the femoral head. The pathway of biological events by which this is accomplished has not been fully elucidated. BMP-2 is a key mediator of bone development and repair, and is uniquely require...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670710014833
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Hip fracture (HF) in frail elderly patients is associated with poor physical recovery and death. There is often postoperative blood loss and the hemoglobin (Hb) threshold for red blood cell (RBC) transfusions in these patients is unknown. We investigated whether RBC transfusion strategies were as...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.3109/17453674.2015.1006980
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:The in vivo pharmacokinetics of gentamycin- loaded collagen fleeces in humans have not been described in the current literature. We therefore analyzed in vivo pharmacokinetics of these fleeces when used in the treatment of periprosthetic infections. PATIENTS AND METHODS:Gentamycin concentrations were measur...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670810016650
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Surgical treatment of chronic acromioclavicular joint dislocations is challenging, and no single procedure can be considered to be the gold standard. In 2010, the GraftRope method (Arthrex Inc., Naples, FL) was introduced in a case series of 10 patients, showing good clinical results and no compl...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2014.976806
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We have previously reported that the first 10 years of hip arthroplasty in Lithuania resulted in a higher cumulative revision rate than that observed in Sweden. We thus compared the corresponding results after introduaction of total knee replacement in Lithuania. METHODS:The 10-year revision rat...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670902804984
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Most lung cancer patients with skeletal metastases have a short survival and it is difficult to identify those patients who will benefit from palliative surgery. We report complication and survival rates in a consecutive series of lung cancer patients who were operated for symptomatic skeletal me...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2011.552779
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Total hip replacement is increasingly used in active, relatively healthy elderly patients with fractures of the femoral neck. Dislocation of the prosthesis is a severe complication, and there is still controversy regarding the optimal surgical approach and its influence on stability. We analyzed factors infl...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453670902930024
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Monoblock acetabular cups represent a subtype of uncemented cups with the polyethylene liner molded into a metal shell, thus eliminating-or at least minimizing-potential backside wear. We hypothesized that the use of monoblock cups could reduce the incidence of osteolysis and aseptic loosening, a...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2012.688726
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:In Legg-Calvé-Perthes disease (LCPD), 4 major patterns (coxa plana, coxa magna, coxa vara, subluxation) of the femoral head are commonly observed. However, direct observation of pathological specimens is rarely possible. An animal model of LCPD may clarify the pathogenesis of femoral head deformity. ANIMALS...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670610045678
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The Knee Injury and Osteoarthritis Outcome Score (KOOS) is distinguished from other knee-specific measures by the inclusion of separate scales for evaluation of activities of daily living, sports and recreation function, and knee-related quality of life, with presentation of separate subscale sco...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2012.747921
更新日期:2012-12-01 00:00:00
abstract::Background and purpose - Total ankle replacement (TAR) is gaining popularity for treatment of end-stage ankle arthritis. Large patient-centered outcome studies are, however, few. Here, we report data from the Swedish Ankle Registry. Patients and methods - We examined outcomes after primary TAR in patients from the Swe...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2017.1366405
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The risk of complications in cirrhosis patients after orthopedic surgery is unclear. We examined this risk after total hip arthroplasty (THA) or total knee arthroplasty (TKA). PATIENTS AND METHODS:Using Danish healthcare registries, we identified all Danish residents who underwent a THA or TKA f...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2014.961397
更新日期:2015-02-01 00:00:00
abstract::Background and purpose - To date there is a lack of studies defining the anatomical position of the proximal fibula. This is especially relevant when planning surgical interventions affecting the knee joint such as permanent or temporary epiphysiodesis to correct leg length discrepancies or angular deformities in grow...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2020.1769378
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Rotational osteotomies are usually necessary to correct pronounced rotational deformities in ambulant children with cerebral palsy. The effects of soft tissue surgery on such deformities are unclear. In this retrospective study, we determined whether multilevel soft tissue surgery, performed to c...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453671003587135
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The PRECICE intramedullary limb lengthening system uses a new technique with a magnetic rod and a motorized external remote controller (ERC) with rotational magnetic field. We evaluated the reliability and safety of the PRECICE system. METHODS:We compared our preliminary results with PRECICE in ...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2014.913955
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:After total hip replacement, increased bone metabolism is seen. A local periprosthetic osteopenia can be measured by dual-energy X-ray absorptiometry (DXA), but it is still unkown whether biochemical markers can be used to monitor the local remodeling at an earlier stage. PATIENTS AND METHODS:In this prospe...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670710013717
更新日期:2007-04-01 00:00:00
abstract::Background and purpose - Up to 20% of patients are dissatisfied after total knee arthroplasty (TKA), mainly because of pain and restricted physical function. We developed a prediction model for 6-month knee range of motion, knee pain, and walking limitations in patients undergoing TKA surgery. Patients and methods - W...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2018.1560647
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:By arthroscopy, we observed a phenomenon that, according to our knowledge not previously described, we call the "biceps tendon footprint" (BTF)--an area of chondromalacia beside the bicipital groove. PATIENTS AND METHODS:We studied 118 shoulder arthroscopies prospectively. We documented whether a BTF could ...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/00016470510030634
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Degree of satisfaction with a knee arthroplasty is said to be correlated to reduced pain and better function. During a validation of the Swedish Knee Arthroplasty Register in 1997, previously operated patients were asked how satisfied they were with their knee. A subgroup of "satisfied" patients was identifi...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670510045372
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:When surgical treatment of dysplastic hip osteoarthrosis is necessary, osteotomy is preferable to fusion or THR. We evaluated periacetabular osteotomy as a method of choice. PATIENTS AND METHODS:We treated 36 symptomatic dysplastic hip joints (32 patients) with the Bernese periacetabular osteotomy (PAO) bet...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/00016470510030346
更新日期:2005-02-01 00:00:00