Tobramycin in bone cement. An in-depth analysis of wound, serum, and urine concentrations in patients undergoing total hip revision arthroplasty.

ABSTRACT

In this prospective clinical study, ten patients were treated by revision of total hip arthroplasties utilizing tobramycin-impregnated bone cement. After the operation, serum, urine, and wound suction drainage concentrations of tobramycin were determined serially by radioimmunoassay. Although high local wound concentrations, 5.7 micrograms/ml, were maintained for as long as 48 hours, serum concentration never reached even normal therapeutic ranges (greater than 2.0 micrograms/ml). There were no immediate postoperative infections; all patients are pain-free and ambulate without external support two years after surgery. One patient who had had a preoperative infection was successfully treated for late manifestation of infection 24 months after revision. Based on the evidence obtained in this study, tobramycin in bone cement is currently acceptable for clinical use.