The Effect of Implanting Gentamicin‐Impregnated Polymethylmethacrylate Beads in the Tarsocrural Joint of the Horse

Farnsworth, Kelly D.; White, Nathaniel A.; Robertson, John L.

doi:10.1053/jvet.2001.21392

Cited by 39 publications

(23 citation statements)

References 22 publications

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“…The study also suggests that higher morbidity was not associated with more aggressive therapies. This is consistent with other authors who have advocated the use of arthrotomy [3], arthroscopy [15,29,28], regional perfusion [27,20,23] and antibiotic-impregnated beads [5,7,6] to facilitate in the treatment of septic arthritis in horses.…”

Section: Discussionsupporting

confidence: 91%

Analysis of factors influencing prognosis in foals with septic arthritis

Vos

Ducharme

2008

Ir Vet J

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The purpose of this paper was to identify factors that would positively or negatively affect the short-term survival rate of foals with septic arthritis. Medical records of 81 foals (≤seven months of age) with a clinical diagnosis of septic arthritis, referred to the equine hospital at Cornell University Hospital for Animals, between 1994 and 2003 were reviewed. Signalment, age at presentation, number of affected joints, joint fluid parameters, bacterial agents, treatment modalities and year of treatment were compared between survivors and nonsurvivors. Sixty-two of 81 foals (77%) were discharged from the hospital and classified as 'survivors'. Multiple joint involvement and detection of intra-articular Gram-negative, mixed bacterial infection and degenerate neutrophils were negatively associated with short-term survival. Initiation of treatment within 24 hrs of onset of clinical signs and combination of treatment modalities were positively correlated with survival. Further investigation is needed to determine if these two factors have a similar influence on athletic performance.

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Section: Discussionsupporting

confidence: 91%

Analysis of factors influencing prognosis in foals with septic arthritis

Vos

Ducharme

2008

Ir Vet J

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“…28 Gentamicin-impregnated polymethylmethacrylate beads containing 300 mg of gentamicin implanted into tarsocrural joints of horses have resulted in mean peak gentamicin concentrations in synovial fluid of 27.9 μg/mL. 29 Continuous infusion of gentamicin at a rate of 0.17 mg/kg/h into the tarsocrural joints of horses has been achieved by use of a balloon infusion system, with concentrations up to 3,510 μg/mL attained in synovial fluid. 9 Biodegradable drug delivery systems offer the advantage of sustained release following implantation at the initial time of treatment, without the need for a second surgical procedure to remove the carrier.…”

mentioning

confidence: 99%

Gentamicin concentrations in synovial fluid obtained from the tarsocrural joints of horses after implantation of gentamicin-impregnated collagen sponges

Ivester

Adams²,

Moore³

et al. 2006

ajvr

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Implantation of a gentamicin-impregnated collagen sponge in the tarsocrural joint of horses resulted in rapid release of gentamicin, with peak concentrations > 20 times the minimum inhibitory concentration reported for common pathogens that infect horses. A rapid decrease in synovial fluid gentamicin concentrations was detected. The purified bovine type I collagen sponges did not elicit substantial inflammation in the synovial membrane or cause mechanical trauma to the articular cartilage.

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“…Since PMMA beads are non-absorbable, they often necessitate a second surgery for bead removal (Calhoun 1989;Kanellakopoulou 2000), which typically takes place 2-4 weeks after implantation (Cierny 1985;Kanellakopoulou 1989;Henry1993). Long term placement of AIPMMA beads 36 may result in trauma to surrounding tissues and lead to pain (Farnsworth 2001), adding to the importance of bead removal. In cases where the surgery for bead removal is delayed for long periods of time, it may be easier to remove beads incorporated onto nonabsorbable suture material because if the absorbable suture material disintegrates, the beads could become loose in a body cavity.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, bacterial isolates such as Actinobacillus spp., Staphylococcus spp., Salmonella typhimurium, and E. coli are susceptible to gentamicin sulfate concentrations of = 2 µg/mL (Adamson 1985;. Synovial fluid concentrations of gentamicin = 2 µg/mL are sustained for 9 days, following implantation of one hundred and twenty, 3.2 mm diameter gentamicin sulfate-impregnated PMMA beads, into the tarsocrural joint of horses (Farnsworth 2001). In the current study, the elution of antibiotic from ten 6-mm MET/GENT beads had decreased to a mean of 76.…”

Section: Gram-negative Organisms Including Pseudomonas Aeruginosa Ementioning

confidence: 99%

Elution of Metronidazole and Gentamicin from Polymethylmethacrylate Beads

et al. 2003

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(ABSTRACT)Ten polymethylmethacrylate (PMMA) beads containing metronidazole (3 concentrations); gentamicin sulfate; or metronidazole and gentamicin sulfate were immersed in 5 ml of phosphate buffered saline in triplicate. Eluent was replaced at specified time intervals for 1 day (1, 3, 6, 12 and 24 hours), daily, or weekly for 21 days.Antibiotic concentrations were measured by High Performance Liquid Chromatography.Changes in antibiotic bioactivity attributable to polymerization or co-polymerization of the antibiotics with PMMA, ethylene oxide sterilization, and storage of antibioticimpregnated PMMA (AIPMMA) beads containing metronidazole were evaluated.Antibiotic elution patterns were similar for all groups. Day-1 elution for groups containing either metronidazole (3 concentrations) or gentamicin represented a mean 63% to 66% and 79% respectively of the 21-day total elution. Approximately 50% of the day-1 elution occurred during the first hour. The elution of metronidazole was dosedependent. There was no significant difference in the total amount of antibiotic eluted from groups that had the saline changed daily versus weekly. The elution of metronidazole (day 3-21) and gentamicin (all days) was significantly greater when metronidazole and gentamicin were combined (p<0.05). Polymerization of PMMA was delayed in groups containing metronidazole.Neither polymerization nor copolymerization of metronidazole and gentamicin with PMMA, gas-sterilization, or 2-month storage of beads containing metronidazole significantly affected antimicrobial bioactivity.Metronidazole elutes from PMMA. The frequency at which the saline was changed did not affect the rate of antibiotic elution.

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The Effect of Implanting Gentamicin‐Impregnated Polymethylmethacrylate Beads in the Tarsocrural Joint of the Horse

Abstract: Temporary intra-articular administration of antibiotic-impregnated PMMA may be an effective way to treat septic joints that require constant high concentrations of antibiotics.

Cited by 39 publications

References 22 publications

Analysis of factors influencing prognosis in foals with septic arthritis

Analysis of factors influencing prognosis in foals with septic arthritis

Gentamicin concentrations in synovial fluid obtained from the tarsocrural joints of horses after implantation of gentamicin-impregnated collagen sponges

Elution of Metronidazole and Gentamicin from Polymethylmethacrylate Beads

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