Role of gentamicin-impregnated cement in total joint arthroplasty

One hundred thirty joint arthroplasties have been performed with the use of PG. A success rate of 86.2 per cent overall and 98.0 per cent where the bacteria were sensitive to the antibiotics has been achieved. In 31 patients with definite infection, one (3.2 per cent) had recurrence. No recurrence of infection was observed in the two-stage reimplantation. Ideally, the antibiotic added to the cement should be specific for the bacteria and the arthroplasty should be reimplanted in two stages. Although the current recurrence rate for infection (3.8 per cent) is not statistically significant compared with historic controls (10 per cent), it does show a marked trend toward improvement. In addition, there have been no adverse effects from the gentamicin, and the inferior intrusion properties of PG have not been reflected in the clinical or radiographic results. Longer follow-up times and larger series are necessary to confirm the findings previously discussed.