We wanted to study the risk of systemic toxic effect of gentamycin/vancomycin loaded spacers, and to investigate whether there is any difference in the elution of gentamycin and vancomycin to the joint fluid between theatre- made and in factory ready-made spacers The study consists of 28 patients. In group one, 14 patients were given a in factory ready-made spacer containing gentamycin 1,1g – 3,2g and vancomycin 1,1g – 3,2g depending of the size of the spacer. In group two, 14 patients were given spacers made in the operating theatre. from PMMA containing 0,5 g gentamycin in each 40 g batch. 4 g vancomycin were added to each batch of 40 g PMMA. The concentration of gentamycin and vancomycin was measured from drainfluid and in serum day 1 and 2 after the operation Group one Group two Significance Vancomycin drain day 1 10,3 (2,0–23.3) 88,5 (11,7–242,9) p<0,001 Vancomycin drain day 2 6,3 (2,0–17,5) 55,2 (7,5–161,0) p<0,001 Vancomycin serum day 1 2,0 (2,0–2,0) 1,8 (0,7–2.0) ns Vancomycin serum day 2 2,0 (1,6–2,2) 1,9 (1,0–2,0) ns Gentamycin drain day 1 23,4 (0,5–68,0) 44,3 (11,0–117,5) p=0,05 Gentamycin drain day 2 8,7 (0,8–16,1) 18,0 (6,8–45,3) p<0,005 Gentamycin serum day 1 0,2 (0,2–0,2) 0,3 (0,2–1,3) ns Gentamycin serum day 2 0,2 (0,0–0,2) 0,3 (0,2–1,1) ns In theatre-made spacers had a significant higher concentration of both gentamycin and vancomycin in the joint fluid. Even with very high consentrations of gentamycin and vancomycin in the joint fluid the concentrations in serum were far below the toxic limit and no toxic reactions were observed Gentamycin and vancomycin added to the hip spacers only to a very small degree passes to the circulation system. In theatre-made spacers have a significantly higher elution of gentamycin and vancomycin than in factory ready-made spacers. If a high initial concentration of gentamycin and vancomycin in joint fluid is desired. in theatre-made spacers should be considered.
To evaluate outcome in patients with late onset juvenile scoliosis or adolescent idiopathic scoliosis 15 years or more after Boston brace treatment. 281 of 369 patients (22 men) with late onset juvenile (n=67) or adolescent (n=214) braced at mean 24.7 (range 16-32) years previously, responded to follow-up. Patients answered a standardized questionnaire including demographics, work status, Oswestry Disability Index (ODI) (100 - worst possible), EuroQol (EQ-5D) (1 – best possible), and Scoliosis Research Society - 22 (SRS - 22) (5 - best possible), and had radiological examination.Purpose
Methods
To evaluate comorbidity and health-related quality of life in patients with idiopathic scoliosis. 496 patients treated with Boston brace for idiopathic scoliosis were invited for long-term follow-up. 361 women and 29 men responded. Mean age was 39.2 (4.6) years; mean follow-up time 23.4 (4.3) years. 28 patients had been operated. All patients had radiographs at baseline, brace weaning, and follow-up, and filled in validated self-report questionnaires for evaluation of health-related quality of life.Purpose
Patients and methods
