Radiographic loosening after revision with gentamicin-containing cement for deep infection in total hip arthroplasties

Abstract

Seventy-two infected total hip arthroplasties were revised with cement containing gentamicin and were followed up with regular radiograms for periods of up to six years. The infection healed in 61 cases and persisted in 11. An analysis of the radiographic changes in regard to the signs of loosening showed that about half of the cases with a healed infection had a minimal demarcation between bone and cement. In about one-third of the patients, a radiolucent zone of up to 2 mm in thickness developed during the first one to two years and then seemed to remain stable. In the other cases, a progressive resorption, indicating true loosening, was observed. All the cases with remaining infection (except one patient who died of heart disease) exhibited progressively increasing resorption zones. Progress, however, was possibly slowed by the effects of the gentamicin cement and the systemic antibiotic treatment.