Safeness of Simplex-tobramycin bone cement in patients with renal dysfunction undergoing total hip replacement
Forsythe, Michael E., Crawford, Scott W., Sterling, Greg J., Whitehouse, Sarah L., & Crawford, Ross W. (2006) Safeness of Simplex-tobramycin bone cement in patients with renal dysfunction undergoing total hip replacement. Journal of Orthopaedic Surgery, 14(1), pp. 38-42.
A prospective, consecutive series of six patients with renal dysfunction as defined by abnormal serum creatinine underwent cemented primary THR for osteoarthritis and the elution characteristics of Simplex-Tobramycin bone cement were compared to a previously reported group of nine patients with normal renal function. Blood, urine and drainage fluid specimens were collected for 72hours post-operatively. Very high concentrations of tobramycin were seen in the drainage fluid, with no significant difference between the two groups (p<0.05). Mean serum tobramycin levels peaked at 3hours, and declined rapidly to reach negligible levels at 72hours in both groups with no significant difference (p<0.05). Mean urinary tobramycin concentrations peaked at 12hours, with rapid decline by 48hours in both groups. Tobramycin was excreted significantly more slowly in the patients with renal dysfunction in the first 12hours (p=0.05), but not thereafter. Although serum creatinine levels were higher in the renal group throughout the study, neither group had a significant change at 72hours compared to their preoperative level. Excellent local delivery was achieved with minimal systemic concentrations in both groups and no change in preoperative renal function. Simplex-Tobramycin bone cement is an effective and safe means by which to deliver antibiotic following THR in patients with renal dysfunction.
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|Item Type:||Journal Article|
|Subjects:||Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Orthopaedics (110314)|
|Divisions:||Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering|
|Copyright Owner:||Copyright 2006 Hong Kong Academy of Medicine Press|
|Copyright Statement:||Reproduced in accordance with the copyright policy of the publisher.|
|Deposited On:||27 Nov 2006|
|Last Modified:||29 Feb 2012 23:18|
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