Tobramycin-impregnated cement in total hip replacements.

The clinical effect of adding 1.2 g of tobramycin powder to each 40-g pack of powdered polymethylmethacrylate used in hip replacement surgery was investigated. Fifteen patients underwent total hip replacement in which a cemented femoral prosthesis and a cementless acetabular prosthesis were used. Postoperatively, the tobramycin levels in the blood and in the wound drainage fluid were measured. The serum tobramycin concentrations were low, whereas the wound drainage fluid contained highly effective antibacterial concentrations. There was no evidence of reaction or toxicity to the antibiotic-impregnated bone cement.