Audiometric threshold shifts after total knee arthroplasty by using gentamicin-loaded bone cement

Authors: ADEM ÇÖBDEN, İSMET YALKIN ÇAMURCU, SERAP BULUT ÇÖBDEN, HAKAN SOFU, HANİFİ ÜÇPUNAR, AHMET SEVENCAN, HÜSEYİN DEMİREL

Abstract: Background/aim:The aim of this study was to investigate postoperative audiometric threshold shifts in patients who underwent primary total knee arthroplasty (TKA) using gentamicin-loaded bone cement (GLBC) in comparison with the ones who underwent TKA without GLBC.Materials and methods: Forty patients (gentamicin group) who underwent primary TKA usingGLBC and 29 patients (control group) who underwent primary TKA using standard bone cement were included in this prospective case-control study. Baseline pure-tone audiometric evaluation was performed preoperatively and repeated at the postoperative third day for all patients. Control audiometric evaluation was performed weekly for patients who were diagnosed with ototoxicity according to audiometric threshold shifts. Results:Ototoxicity was diagnosed in 8 of 40 patients (20%) in the gentamicin group according to postoperative audiometric threshold shifts, whereas no ototoxicity was observed in the control group. Patients who were diagnosed with ototoxicity had no permanent audiometric threshold shifts in follow-up audiometric evaluation and these patients had no clinical complaints of difference in hearing. Conclusion:According to our results, audiometric threshold shifts can be detected in patients who undergo primary TKA using gentamicin loaded bone cement. However, no permanent shifts were observed during close follow-up.

Keywords: Gentamicin, ototoxicity, total knee arthroplasty, antibiotic-loaded bone cement, audiometry

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