{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T06:50:07Z","timestamp":1785912607873,"version":"3.56.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"7-8","license":[{"start":{"date-parts":[[2012,7,1]],"date-time":"2012-07-01T00:00:00Z","timestamp":1341100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Aminoglycoside-loaded bone cement (ALBC) implants are frequently used in orthopedic surgery. Parenteral aminoglycosides are known to cause nephrotoxicity. Reports of acute renal failure in patients receiving ALBC implants have been reported in the literature and at our hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To evaluate, as part of a performance improvement project, whether patients undergoing arthroplasty procedures have detectable aminoglycoside serum concentrations following ALBC implantation and to evaluate corresponding changes in serum creatinine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Patients undergoing hip or knee revision or resection4-up clinic visit when possible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Seventeen patients were evaluated: 13 women and 4 men with a mean age of 69 years (range 50-84). Eight patients had a preoperative diagnosis of infection and received high-dose ALBC implants as treatment and 9 patients received lower-dose ALBC implants for infection prophylaxis. Eight patients had detectable aminoglycoside serum concentrations (mean 0.42 \u03bcg\/mL; range 0.3 to 2.0); 1 patient had an aminoglycoside serum concentration of 0.9 \u03bcg\/mL on postoperative day 38. Patients who did not have a detectable aminoglycoside serum concentration on the first postoperative day did not have a detectable concentration in the following serum samples. Six patients had elevation of serum creatinine by greater than 0.3 mg\/dL from baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The number of patients in this study is small; however, this report raises a potential concern for the safety of high-dose ALBC implants. We recommend measuring aminoglycoside serum concentrations in the early postoperative period to identify patients in need of further monitoring. Further studies are needed to determine risk factors for systemic toxicity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1r049","type":"journal-article","created":{"date-parts":[[2012,7,4]],"date-time":"2012-07-04T15:46:47Z","timestamp":1341416807000},"page":"929-934","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Systemic Exposure to Aminoglycosides following Knee and Hip Arthroplasty with Aminoglycoside-Loaded Bone Cement Implants"],"prefix":"10.1177","volume":"46","author":[{"given":"Graziela Z","family":"Kalil","sequence":"first","affiliation":[{"name":"Graziela Z Kalil PharmD, Postdoctoral Research Fellow, Roy and Lucille Carver College of Medicine, University of Iowa; Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika J","family":"Ernst","sequence":"additional","affiliation":[{"name":"Erika J Ernst PharmD, Associate Professor, Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa; Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah J","family":"Johnson","sequence":"additional","affiliation":[{"name":"Sarah J Johnson PharmD, Clinical Pharmacy Specialist, Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics; Clinical Assistant Professor, College of Pharmacy, University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgir","family":"Johannsson","sequence":"additional","affiliation":[{"name":"Birgir Johannsson MD, Clinical Assistant Professor, Department of Internal Medicine, Division of Infectious Diseases, University of Iowa Hospitals and Clinics; Roy and Lucille Carver College of Medicine, University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip M","family":"Polgreen","sequence":"additional","affiliation":[{"name":"Philip M Polgreen MD MPH, Associate Professor, Department of Internal Medicine, Division of Infectious Diseases, University of Iowa Hospitals and Clinics; Roy and Lucille Carver College of Medicine, University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Andrew","family":"Bertolatus","sequence":"additional","affiliation":[{"name":"J Andrew Bertolatus MD, Associate Professor, Department of Internal Medicine, Division of Nephrology, University of Iowa Hospitals and Clinics; Roy and Lucille Carver College of Medicine, University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles R","family":"Clark","sequence":"additional","affiliation":[{"name":"Charles R Clark MD, Professor, Department of Orthopaedic Surgery & Rehabilitation, University of Iowa Hospitals and Clinics; Roy and Lucille Carver College of Medicine, University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,7,1]]},"reference":[{"key":"bibr1-aph.1R049","unstructured":"Congressional research service (CRS) report for Congress. The US approval process for medical devices: legislative issues and comparison with the drug model (2005 March 23). www.law.umaryland.edu\/marshall\/crsreports\/crsdocuments\/RL3282603232005.pdf (accessed 2012 Mar 8)."},{"key":"bibr2-aph.1R049","unstructured":"Food and Drug Administration. www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfPCD\/classification.cfm (accessed 2011 Jul 15)."},{"key":"bibr3-aph.1R049","volume-title":"Package insert. Tobramycin (tobramycin sulfate) powder, lyophilized, for solution","year":"2009"},{"key":"bibr4-aph.1R049","volume-title":"Package insert. Gentamicin (gentamicin sulfate), injection, solution concentrate","year":"2005"},{"key":"bibr5-aph.1R049","volume-title":"Package insert. 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