Minimum 5 years' follow-up after gentamicin- and clindamycin-loaded PMMA cement in total joint arthroplasty.

Abstract

Due to numerous advantages of the combination of clindamycin and gentamicin in polymethylmethacrylate (PMMA) cement, promising preliminary results have been reported. However, there are no data that analyse mid-term outcomes. This pilot study included patients who experienced 5 years of follow-up and who were treated with gentamicin- and clindamycin-loaded (G+C) PMMA cement. They were divided into two groups: (1) the periprosthetic joint infection (PJI) comprising patients who underwent a one-stage exchange, and (2) aseptic group comprising patients who underwent aseptic revision or primary arthroplasty procedures, but were considered to be high-risk patients for infection. We evaluated the rate of septic and aseptic revision arthroplasty with a minimum of 5-year follow-up.Results/Key findings. A total of 32 patients in both groups were included. Eighteen patients belonged to the PJI-group and 14 belonged to the aseptic group. There was no reinfection among the patients of the PJI group. Infection was prevented in the aseptic group, including patients with a history of PJI or at higher risk of infection. No patient underwent an exchange of the cemented prosthesis at the 5-year follow-up [72-82 months, standard deviation (sd)=3.3]. The local use of G+C bone cement during septic and aseptic revision arthroplasty, was associated with a high success rate for the eradication of infection following one-stage septic exchange, and with prevention of infection in high-risk patients.