{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:03:39Z","timestamp":1791227019271,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2006,6,20]],"date-time":"2006-06-20T00:00:00Z","timestamp":1150761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2006,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study investigated the release of antibiotics in vivo, from an articulating polymethylmethacrylate (PMMA) spacer used in two\u2010stage revision arthroplasty of infected hip implants. Forty\u2010six patients who underwent two\u2010stage revision hip arthroplasty for infections were managed with an interim PMMA spacer loaded with a high dose of vancomycin and aztreonam. Serum and aliquots of drainage collected after the first\u2010stage surgery, and joint fluid obtained at the time of the second\u2010stage surgery were analyzed for antibiotic concentrations by high performance liquid chromatography and bioactivity by tube dilution bioassay. Following implantation, the highest levels of antibiotics were measured in aliquots of drainage on the first day (vancomycin: 1538.0\u2009\u00b1\u2009243.6 \u00b5g\/mL; aztreonam: 1003.5\u2009\u00b1\u2009323.5 \u00b5g\/mL), decreasing to 571.9\u2009\u00b1\u2009169.4 \u00b5g\/mL for vancomycin and 313.6\u2009\u00b1\u200988.3 \u00b5g\/mL for aztreonam after 7 days. Antibiotic concentrations in serum were very low (vancomycin: 0.58\u2009\u00b1\u20090.2 \u00b5g\/mL, range: 0.1\u20131.6 \u00b5g\/mL; aztreonam: 0.46\u2009\u00b1\u20090.3 \u00b5g\/mL, range: 0.1\u20130.9 \u00b5g\/mL at 24 h) and there was no systemic adverse effect. At a mean 107 days after the first\u2010stage surgery, the concentrations of antibiotics in joint fluid were well above the minimal inhibitory concentration of most common microorganisms. The released antibiotics were bioactive against the test organisms. Based on the observed results, we confirmed the safety and effectiveness of in vivo drug delivery from antibiotic\u2010impregnated PMMA hip spacers. \u00a9 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 24:1615\u20131621, 2006<\/jats:p>","DOI":"10.1002\/jor.20214","type":"journal-article","created":{"date-parts":[[2006,6,20]],"date-time":"2006-06-20T18:05:42Z","timestamp":1150826742000},"page":"1615-1621","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":121,"title":["High concentration and bioactivity of vancomycin and aztreonam eluted from Simplex\u2122 cement spacers in two\u2010stage revision of infected hip implants: A study of 46 patients at an average follow\u2010up of 107 days"],"prefix":"10.1002","volume":"24","author":[{"given":"Pang\u2010Hsin","family":"Hsieh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Han","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih\u2010Hao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve W.N.","family":"Ueng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Hsiung","family":"Shih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,7,10]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-002-3079-9"},{"key":"e_1_2_1_3_2","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.2106\/00004623-199173100-00003","article-title":"The use of bone allografts in two\u2010stage reconstruction after failure of hip replacements due to infection","volume":"73","author":"Berry DJ","year":"1991","journal-title":"J Bone Joint Surg [Am]"},{"key":"e_1_2_1_4_2","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/00003086-199401000-00012","article-title":"Surgical treatment of the infected hip implant. 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