Acute renal failure after antibiotic-impregnated bone cement treatment of an infected total knee arthroplasty

Acute renal failure after high-dose antibiotic bone cement: case report and review of the literature

“…25 In almost all cases there was a documented systemic antibiotic level attributed to bone cement elution that could have played a role in the acute renal failure. 19,[22][23][24][25][26]28,29 McGlothan and Gosmanova did not report serum antibiotic levels that could be attributed solely to cement leaching, but still considered that the ALBC was the likely cause since the renal function resolved fairly soon after explantation. 27 In the low-dose ALBC primary prophylaxis case reported by Lau and Kumar, levels were neither drawn nor was the spacer explanted, but the authors still deemed the gentamicin spacer to be the probable cause with a Naranjo score of 6 out of 10.…”

“…24,30 The renal function eventually resolved in most cases, but one case was not clear 22 and another still required hemodialysis five months post-explantation. 25 In almost all cases there was a documented systemic antibiotic level attributed to bone cement elution that could have played a role in the acute renal failure.…”

“…The authors did report vestibular damage in one patient, but it was attributed to a high vancomycin level due to systemic administration. 21 Since 2005, there have been numerous cases of acute renal failure that occurred after orthopedic implantation of highdose ALBC, 22,23,[25][26][27][28][29] low-dose ALBC used for treatment 24 and one case after low-dose ALBC used for prophylaxis in a primary total knee arthroplasty. 30 Most of these case reports required hemodialysis 19,22,[24][25][26]29,30 and explantation of the spacers.…”

One-stage Revision With Catheter Infusion of Intraarticular Antibiotics Successfully Treats Infected THA

“…By contrast, singlestage revision procedures performed with or without cement fixation also are used [5,33,58], and no clear evidence exists that two-stage revision yields superior results to single-stage protocols [5,14,18,21,23,33,58]. Additionally, the interim antibiotic cement spacers associated with two-stage exchange may carry some risk including dislocation of the spacer [15,26,43], fracture of the hip [15], fracture of the spacer [9,15,26], migration of the spacer leading to bone damage or even vascular injury [48], rare reports of renal injury from antibiotic elution, and the need to remove the spacershould these complications occur [1,10,13,37,40,42,52].…”

Success After Treatment of Periprosthetic Joint Infection: A Delphi-based International Multidisciplinary Consensus

“…Avoidance of medical and surgical complications can also be considered a goal of the PJI treatment [11,18].…”