Acute Kidney Injury After Placement of an Antibiotic-Impregnated Cement Spacer During Revision Total Knee Arthroplasty

2012 ◽  
Vol 27 (6) ◽  
pp. 1221-1227.e2 ◽  
Author(s):  
Travis J. Menge ◽  
John R. Koethe ◽  
Cathy A. Jenkins ◽  
Patty W. Wright ◽  
Andrew A. Shinar ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Kidney Injury ◽  
Revision Total Knee Arthroplasty ◽  
Cement Spacer ◽  
Total Knee

scholarly journals Greater Rates of Acute Kidney Injury in African American Total Knee Arthroplasty Patients

2019 ◽  
Vol 34 (6) ◽  
pp. 1240-1243
Author(s):  
Tanner N. Womble ◽  
John D. King ◽  
Dustin H. Hamilton ◽  
Max A. Shrout ◽  
Cale A. Jacobs ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Total Knee Arthroplasty ◽  
African American ◽  
Knee Arthroplasty ◽  
Kidney Injury ◽  
Total Knee

scholarly journals Early postoperative albumin level following total knee arthroplasty is associated with acute kidney injury

Medicine ◽  
2016 ◽  
Vol 95 (31) ◽  
pp. e4489 ◽  
Author(s):  
Ha-Jung Kim ◽  
Won-Uk Koh ◽  
Sae-Gyeol Kim ◽  
Hyeok-Seong Park ◽  
Jun-Gol Song ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Kidney Injury ◽  
Albumin Level ◽  
Total Knee

scholarly journals Effect of Anesthetic Technique on the Occurrence of Acute Kidney Injury after Total Knee Arthroplasty

2019 ◽  
Vol 8 (6) ◽  
pp. 778 ◽  
Author(s):  
Ha-Jung Kim ◽  
Hee-Sun Park ◽  
Yon-Ji Go ◽  
Won Uk Koh ◽  
Hyungtae Kim ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Total Knee Arthroplasty ◽  
Spinal Anesthesia ◽  
Knee Arthroplasty ◽  
Lower Risk ◽  
Kidney Injury ◽  
Anesthetic Technique ◽  
Anesthesia Group ◽  
Total Knee ◽  
Spinal Anesthesia Group

Recent studies have reported the advantages of spinal anesthesia over general anesthesia in orthopedic patients. However, little is known about the relationship between acute kidney injury (AKI) after total knee arthroplasty (TKA) and anesthetic technique. This study aimed to identify the influence of anesthetic technique on AKI in TKA patients. We also evaluated whether the choice of anesthetic technique affected other clinical outcomes. We retrospectively reviewed medical records of patients who underwent TKA between January 2008 and August 2016. Perioperative data were obtained and analyzed. To reduce the influence of potential confounding factors, propensity score (PS) analysis was performed. A total of 2809 patients and 2987 cases of TKA were included in this study. A crude analysis of the total set demonstrated a significantly lower risk of AKI in the spinal anesthesia group. After PS matching, the spinal anesthesia group showed a tendency for reduced AKI, without statistical significance. Furthermore, the spinal anesthesia group showed a lower risk of pulmonary and vascular complications, and shortened hospital stay after PS matching. In TKA patients, spinal anesthesia had a tendency to reduce AKI. Moreover, spinal anesthesia not only reduced vascular and pulmonary complications, but also shortened hospital stay.

scholarly journals Comparing Inpatient Complication Rates between Octogenarians and Nonagenarians following Primary and Revision Total Knee Arthroplasty in a Nationally Representative Sample, 2010–2014

Geriatrics ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 3 ◽  
Author(s):  
Eric Smith ◽  
Evan Dugdale ◽  
David Tybor ◽  
Michael Kain
Keyword(s):  
Acute Kidney Injury ◽  
Total Knee Arthroplasty ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Mortality Rate ◽  
Kidney Injury ◽  
Revision Total Knee Arthroplasty ◽  
Complication Rates ◽  
Inpatient Mortality ◽  
Total Knee

We compared the inpatient postoperative complication rates between octogenarians and nonagenarians undergoing primary and revision total knee arthroplasty (TKA). We used the Nationwide Inpatient Sample (NIS) to analyze inpatient admission data from 2010–2014. We compared the rates at which nonagenarians and octogenarians developed each complication following both primary TKA (PTKA) and revision TKA (RTKA). A national estimate of 324,933 patients were included in our study. A total of 313,299 (96.42%) were octogenarians, and 11,634 (3.58%) were nonagenarians. 294,462 (90.62%) underwent PTKA, and 30,471 (9.38%) underwent RTKA. Nonagenarians undergoing PTKA had a higher inpatient mortality rate, and developed sepsis more frequently than octogenarians. Nonagenarians undergoing RTKA had a higher inpatient mortality rate, and developed cardiogenic shock more frequently than octogenarians. In both PTKA and RTKA, nonagenarians received transfusions more frequently, and developed urinary tract infection and acute kidney injury more frequently than octogenarians. In both PTKA and RTKA, nonagenarians sustained a higher inpatient mortality rate than octogenarians. Orthopedic surgeons should counsel nonagenarian patients undergoing both PTKA and RTKA preoperatively about this increased mortality risk, as well as the increased risks of more minor complications like transfusion, urinary tract infection, and acute kidney injury.

Can Teicoplanin Be an Effective Choice for Antibiotic-Impregnated Cement Spacer in Two-Stage Revision Total Knee Arthroplasty?

2016 ◽  
Vol 30 (03) ◽  
pp. 283-288 ◽  
Author(s):  
Hakan Sofu ◽  
Ismet Camurcu ◽  
Hanifi Ucpunar ◽  
Mehmet Kaygusuz ◽  
Vedat Sahin ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Cement Spacer ◽  
Two Stage ◽  
Total Knee ◽  
Effective Choice

scholarly journals Acute Renal Failure due to a Tobramycin and Vancomycin Spacer in Revision Two-Staged Knee Arthroplasty

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Ronak A. Patel ◽  
Hayden P. Baker ◽  
Sara B. Smith
Keyword(s):  
Renal Failure ◽  
Total Knee Arthroplasty ◽  
Acute Renal Failure ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Cement Spacer ◽  
Two Stage ◽  
Prosthetic Joint Infections ◽  
Total Knee ◽  
Antibiotic Spacer

Two-stage revision total knee arthroplasty (TKA) is the standard of care for prosthetic joint infections. The first stage involves removal of the infected prosthesis and placement of an antibiotic impregnated cement spacer; following a period ranging from 4 weeks to 6 months, the spacer is then removed and replaced with a permanent prosthesis. The advantage to this approach is that antibiotic impregnated spacers provide supratherapeutic levels in the joint without toxic accumulation in serum. However, it remains important for physicians and pharmacists to be aware of antibiotic associated complications in knee revisions. We present a case of a two-stage revision total knee arthroplasty in which a cement antibiotic spacer caused acute renal failure and ultimately resulted in persistent chronic kidney disease without hemodialysis at 2 months’ follow-up. Our case reports the third highest serum tobramycin (13.7 mcg/ml) and second highest serum creatinine (8.62 mg/dl) for patients experiencing ARF due to an antibiotic spacer in two-stage revision TKA.

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