Subscribe to RSS
DOI: 10.3415/VCOT-15-05-0088
Intra-articular implantation of gentamicin impregnated collagen sponge causes joint inflammation and impaired renal function in dogs
The authors received funding for this study from the Pet Trust, Ontario Veterinary College, Ontario, Canada.Publication History
Received:
26 May 2015
Accepted:
20 February 2015
Publication Date:
19 December 2017 (online)
Summary
Objective: Gentamicin impregnated collagen sponge (GICS) can be used to treat intra-articular surgical site infections. High local concentrations of gentamicin can be reached for short periods; however the collagen vehicle may persist for much longer periods. We wished to determine the effect of sponge implantation on joint inflammation and renal function.
Methods: Eighteen medium sized mixed breed research dogs of hound type were randomized to two groups; arthroscopic implantation of GICS at gentamicin dose = 6 mg/kg (n = 9) or sham operation (n = 9). Endpoints consisted of joint inflammation measured by synovial fluid cell counts and cytokine concentrations; lameness measured by force plate asymmetry indices; and renal function measured by glomerular filtration rate (GFR) study. The prevalence of lesions associated with aminoglycoside nephrotoxicity was assessed by renal biopsy and transmission electron microscopy.
Results: Gentamicin impregnated collagen sponge implantation caused joint inflammation (p <0.01), lameness (p = 0.04), and decreased GFR (p = 0.04). No difference was observed in the prevalence of renal lesions on biopsy between the treatment and control groups (p = 0.49).
Clinical significance: Gentamicin impregnated collagen sponge implantation causes joint inflammation and lameness as well as GFR reductions at the dose assessed. Gentamicin impregnated collagen sponge are not recommended for intra-articular implantation in dogs.
-
References
- 1 Bennett-Guerrero E, Pappas TN, Koltun WA. et al. Gentamicin-collagen sponge for infection prophylaxis in colorectal Surgery. N Engl J Med 2010; 363: 1038-1049.
- 2 Attmanspacher W, Dittrich V, Schätzler A. et al. [Mid-term outcome of postoperative infections of the shoulder][Article in German]. Unfallchirurg 2000; 103: 1048-1056.
- 3 Swieringa AJ, Goosen JH, Jansman FG. et al. In vivo pharmacokinetics of a gentamicin-loaded collagen sponge in acute periprosthetic infections: serum values in 19 patients. Acta Orthop 2008; 79: 637-642.
- 4 Schimmer C, Özkur M, Sinha B. et al. Gentamicin-collagen sponge reduces sternal wound complications after heart surgery: A controlled, prospectively randomized, double-blind study. J Thorac Cardiovasc Surg 2012; 143: 194-200.
- 5 Chaudhary S, Sen RK, Saini UC. et al. Use of gentamicin loaded collagen sponge in internal fixation of open fractures. Chin J Traumatol 2011; 14: 209-214.
- 6 Diefenbeck M, Muckley T, Hofmann GO. Prophylaxis and treatment of implant-related infections by local application of antibiotics. Injury 2006; 37 (Suppl. 02) Suppl S95-104.
- 7 Hayes GM, Gibson TW, Moens NM. et al. Intra-articular pharmacokinetics of a gentamicin impregnated collagen sponge in the canine stifle: an experimental study. Vet Surg 2014; 43: 166-173.
- 8 Mehta S, Humprey JS, Schenkman I D. et al. Gentamicin distribution from a collagen carrier. J Orthop Res 1996; 14: 749-754.
- 9 Kilian O, Hossain H, Flesch I. et al. Elution kinetics, antimicrobial efficacy, and degradation and microvasculature of a new gentamicin-loaded collagen fleece. J Biomed Mater Res Part B Appl Biomater 2009; 90: 210-222.
- 10 Swieringa AJ, Tulp NJ. Toxic serum gentamicin levels after the use of gentamicin-loaded sponges in infected total hip arthroplasty. Acta Orthop 2005; 76: 75-77.
- 11 Feldsien JD, Wilke VL, Evans RB. et al. Serum cortisol concentration and force plate analysis in the assessment of pain associated with sodium urate-induced acute synovitis in dogs. Am J Vet Res 2010; 71: 940-945.
- 12 Fitzpatrick N, Smith TJ, Evans RB. et al. Radiographic and arthroscopic findings in the elbow joints of 263 dogs with medial coronoid disease. Vet Surg 2009; 38: 213-223.
- 13 Fanchon L, Grandjean D. Accuracy of asymmetry indices of ground reaction forces for diagnosis of hind limb lameness in dogs. Am J Vet Res 2007; 68: 1089-1094.
- 14 Von Hendy-Willson VE, Pressler BM. An overview of glomerular filtration rate testing in dogs and cats. Vet J 2011; 188: 156-165.
- 15 Rougier F, Claude D, Maurin M. et al. Aminoglycoside nephrotoxicity. Current Drug Targets - Infectious Disorders 2004; 4: 153-162.
- 16 Bennett-Guerro E, Pappas TN, Koltun WA. et al. Gentamicin collagen sponge for infection prophylaxis in colorectal surgery. N Engl J Med 2010; 363: 1038-1049.