Table 2.
Patient ID | Previous Implant Cemented | Weight of 24 h Wound Exudate (g) Collected at | Spacer Characteristics | Antibiotics Concentration in Wound Exudate (μg/mL) | Antibiotics Concentration in Tissue Samples (μg/g) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
IMP | EXP | Spacer Cement | Mold Usedc | Amount (g) of Prepared Cement with [V (g), G (g)] | Period of Implantation (Weeks) | Vancomycin | Gentamicin | Vancomycin | Gentamicin | ||||||
IMP | EXP | IMP | EXP | IMP | EXP | IMP | EXP | ||||||||
H1a | No | 186 | Palacos R+G | M1 | 160 [8.0, 2.0] | 12.6 | 17.46 | n.c. | 20.80 | n.c. | 0.00* | 0.09 | |||
H1 2nd spacer | n.c. | Palacos R+G | n.s. | 40 [2.0, 0.5] | 10.0 | 0.04 | 0.16 | ||||||||
H2b | Yes | 133 | 182 | Palacos R+G | M3 | 160 [8.0, 2.0] | 11.1 | 27.06 | 17.67 | 6.69 | 12.53 | 0.01 | 39.49 | 0.15 | 1.07 |
H3 | No | 302 | 123 | Palacos R+G | M3 | 160 [8.0, 2.0] | 11.7 | 10.37 | 11.37 | 3.67 | 9.44 | 0.00* | 0.26 | 0.01* | 0.13 |
H4b | Yes | 263 | 172 | Palacos R+G | M3 | 160 [8.0, 2.0] | 12.4 | 92.73 | 5.47 | 71.80 | 0.74 | 0.00* | 0.38 | 25.81 | 0.05 |
H5a | No | n.c. | n.c. | Palacos R+G | M3 | 160 [8.0, 2.0] | 11.6 | n.c. | n.c. | n.c. | n.c. | 0.00* | 484.16 | 0.01* | 71.75 |
H6 | No | 167 | Palacos R+G | M3 | 80 [4.0, 1.0] | 2.6 | 43.28 | 21.55 | 0.00* | 0.01* | |||||
H6 2nd spacer | 571 | Palacos R+G | n.s. | 60 [3.0, 0.75] | 15.0 | 0.13* | 53.87 | 0.02 | 0.05 | ||||||
H7 | No | 213 | 98 | Palacos R+G | M1 | 80 [4.0, 1.0] | 11.1 | 50.25 | 37.47 | 23.01 | 12.77 | 0.00* | 0.12 | 0.01* | 0.12 |
H8b | No | 552 | Palacos R+G | n.s. | 40 [2.0, 0.5] | 2.1 | 63.24 | 19.49 | 9.36 | 0.01* | |||||
H8 2nd spacer | 12 | Palacos R+G | M3 | 160 [8.0, 2.0] | 12.3 | 0.44 | 0.01 | 0.23 | 0.70 | ||||||
H9 | No | 478 | 31 | Palacos R+G | M3 | 140 [7.0, 1.75] | 12.7 | 189.05 | 0.82 | 15.63 | 10.32 | 0.00* | 16.31 | 0.01* | 17.98 |
H10 | No | 359 | 357 | Palacos R+G | M3 | 160 [8.0, 2.0] | 11.4 | 27.82 | 0.33 | 9.38 | 17.25 | 0.01 | 0.29 | 0.01* | 0.87 |
K1a | Yes | 425 | n.c. | Palacos R+G | T4+F4 | 160 [8.0, 2.0] | 16.0 | 50.19 | n.c. | 18.73 | n.c. | 0.26 | 0.99 | 42.93 | 0.91 |
K2a | Yes | 384 | n.c. | Copal spacem | T4+F4 | 160 [8.0, 2.0] | 11.6 | 56.18 | n.c. | 7.06 | n.c. | 0.00* | 26.20 | 1.50 | 3.92 |
K3 | Yes | 151 | Palacos R+G | T3+F3 | 120 [6.0, 1.5] | 2.0 | 0.28 | 52.54 | 0.01 | 18.83 | |||||
K3 2nd spacer | 399 | Palacos R+G | T4+F4 | 180 [2.25, 9.0] | 18.4 | 0.62 | 104.02 | 0.37 | 3.84 | ||||||
K4 | Yes | 174 | 367 | Copal spacem | T2+F2 | 120 [6.0, 1.5] | 9.3 | 93.58 | 0.13* | 5.82 | 9.14 | 0.00* | 0.03 | 1.35 | 0.01* |
K5 | No | 324 | 180 | Palacos R+G | T3+F3 | 120 [6.0, 1.5] | 9.3 | 261.22 | 0.37 | 15.28 | 17.53 | 0.00* | 0.07 | 0.01* | 0.05 |
K6 | Yes | 447 | 93 | Palacos R+G | T4+F4 | 160 [8.0, 2.0] | 12.1 | 27.61 | 30.32 | 12.71 | 11.64 | 0.00* | 0.99 | 31.83 | 6.24 |
K7 | Yes | 193 | 542 | Copal spacem | T4+F4 | 160 [8.0, 2.0] | 13.9 | 33.51 | 0.13* | 14.74 | 59.17 | 0.00* | 0.32 | 1.70 | 0.41 |
K8 | Yes | 177 | 5 | Palacos R+G | T3+F3 | 160 [8.0, 2.0] | 14.9 | 143.09 | 0.46 | 84.60 | 8.40 | 0.00* | 15.03 | 8.45 | 19.13 |
All values excluded from the statistical analysis and from depiction in Figures 1 and 2 are underlaid in gray.
Abbreviations: H = hip patient; K = knee patient; IMP = spacer implantation; EXP = spacer explantation; V = vancomycin; G = gentamicin; n.c. = not collected.
Patient excluded from analysis of wound exudate due to missing sample at spacer explantation.
Patient excluded from analysis of vancomycin release due to systemic antibiotics therapy with vancomycin at time point of sample collection.
Spacer molds hip with stem size/head size: spacer mold 1 (M1) with 9 × 125 mm/43 mm; spacer mold 2 (M2) 9 × 125 mm/51 mm; spacer mold 3 (M3) 13 × 145 mm/57 mm; spacer mold 4 (M4) 17 × 165 mm/64 mm. Spacer molds knee with tibia and femur: spacer mold tibia 1 (T1) 65 mm M/Lx 39 mm A/P; spacer mold tibia 2 (T2) 70 mm M/Lx 42 mm A/P; spacer mold tibia 3 (T3) 75 mm M/Lx 45 mm A/P; spacer mold tibia 4 (T4) 80 mm M/Lx 48 mm A/P; spacer mold femur 1 (F1) 60 mm M/Lx 43 mm A/P; spacer mold femur 2 (F2) 65 mm M/Lx 48 mm A/P; spacer mold femur 3 (F3) 70 mm M/Lx 52 mm A/P; spacer mold femur 4 (F4) 75 mm M/Lx 57 mm A/P.
Values below the detection limit. Lower limit of quantification (LLOQ) for gentamicin were 0.008 μg/g in periprosthetic membrane samples and 0.004 μg/mL in wound exudates, LLOQs for vancomycin were 0.0025 μg/g in periprosthetic membrane samples and 0.125 μg/mL in wound exudates. Values below the detection limit were set at the value of the LLOQ for depiction and statistical analysis.