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.

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

Outcomes of single- and two-stage revision total knee arthroplasty for chronic periprosthetic joint infection

2021 ◽  
Vol 103-B (8) ◽  
pp. 1373-1379
Author(s):  
Hosam E. Matar ◽  
Benjamin V. Bloch ◽  
Susan E. Snape ◽  
Peter J. James
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Joint Infection ◽  
Recurrent Infection ◽  
Primary Outcome Measure ◽  
Revision Total Knee Arthroplasty ◽  
Single Stage ◽  
Two Stage ◽  
Joint Infections ◽  
Total Knee

Aims Single-stage revision total knee arthroplasty (rTKA) is gaining popularity in treating chronic periprosthetic joint infections (PJIs). We have introduced this approach to our clinical practice and sought to evaluate rates of reinfection and re-revision, along with predictors of failure of both single- and two-stage rTKA for chronic PJI. Methods A retrospective comparative cohort study of all rTKAs for chronic PJI between 1 April 2003 and 31 December 2018 was undertaken using prospective databases. Patients with acute infections were excluded; rTKAs were classified as single-stage, stage 1, or stage 2 of two-stage revision. The primary outcome measure was failure to eradicate or recurrent infection. Variables evaluated for failure by regression analysis included age, BMI, American Society of Anesthesiologists grade, infecting organisms, and the presence of a sinus. Patient survivorship was also compared between the groups. Results A total of 292 consecutive first-time rTKAs for chronic PJI were included: 82 single-stage (28.1%); and 210 two-stage (71.9%) revisions. The mean age was 71 years (27 to 90), with 165 females (57.4%), and a mean BMI of 30.9 kg/m2 (20 to 53). Significantly more patients with a known infecting organism were in the single-stage group (93.9% vs 80.47%; p = 0.004). The infecting organism was identified preoperatively in 246 cases (84.2%). At a mean follow-up of 6.3 years (2.0 to 17.6), the failure rate was 6.1% in the single-stage, and 12% in the two-stage groups. All failures occurred within four years of treatment. The presence of a sinus was an independent risk factor for failure (odds ratio (OR) 4.97; 95% confidence interval (CI) 1.593 to 15.505; p = 0.006), as well as age > 80 years (OR 5.962; 95% CI 1.156 to 30.73; p = 0.033). The ten-year patient survivorship rate was 72% in the single-stage group compared with 70.5% in the two-stage group. This difference was not significant (p = 0.517). Conclusion Single-stage rTKA is an effective strategy with a high success rate comparable to two-stage approach in appropriately selected patients. Cite this article: Bone Joint J 2021;103-B(8):1373–1379.

The Use of Spacers in Two-Stage Revision Total Knee Arthroplasty

2018 ◽  
Vol 26 (23) ◽  
pp. e496
Author(s):  
Federica Rosso ◽  
Davide E. Bonasia ◽  
Umberto Cottino ◽  
Federico Dettoni ◽  
Matteo Bruzzone ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Two Stage ◽  
Total Knee

Extended Oral Antibiotics and Infection Prophylaxis after a Primary or Revision Total Knee Arthroplasty

2019 ◽  
Vol 33 (02) ◽  
pp. 111-118 ◽  
Author(s):  
Cierra S. Hong ◽  
Collin S. Black ◽  
Sean P. Ryan ◽  
Thorsten M. Seyler
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Infection Prophylaxis ◽  
Oral Antibiotics ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Total Knee

AbstractOne of the most common reasons for failure of primary total knee arthroplasty and need for revision surgery is periprosthetic infection. Antibiotics are one of the mainstays of treatment to address prosthetic joint infections, but the route of administration and timing of delivery to optimize patient outcomes are debated. This article reviews the use and attributes of commonly used oral antibiotics, especially extended or long-term utilization, as prophylaxis and treatment for prosthetic joint infections in a primary or revision total knee arthroplasty, which include debridement, antibiotics, and implant retention, one-stage and two-stage exchange arthroplasty.

scholarly journals An Unusual Complication after Infected Total Knee Arthroplasty

Joints ◽  
2018 ◽  
Vol 06 (04) ◽  
pp. 241-245
Author(s):  
Giuseppe Solarino ◽  
Giuseppe Maccagnano ◽  
Michele Saracino ◽  
Biagio Moretti
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Short Form ◽  
Unusual Complication ◽  
Cement Spacer ◽  
X Rays ◽  
Two Stage ◽  
Hybrid External Fixator ◽  
Infected Total Knee Arthroplasty ◽  
Total Knee

AbstractOne-stage or two-stage revision total knee arthroplasty (TKA) in periprosthetic joint infections has been at the center of scientific debate for many years. As regards two-stage revision TKA, cement spacers have a good infection control rate with successful results reportable up to 96%, though some studies describe related spacer complications such as stiffness and loss of bone stock. We report a case of a fracture close to the antibiotic-loaded cement spacer in a 74-year-old female patient. Due to the blood tests and high risk of infection, we performed a hybrid external fixator. Six months after the surgery, X-rays did not show signs of fracture consolidation and nonunion was considered as an impending complication; therefore, the decision was made to perform tumor-like total knee arthroplasty. The postoperative evolution was satisfactory and return to daily activity without pain. At the 5-year follow-up, the patient showed a good score of 36-Item Short Form Health Survey and a range of motion from 0 to 90° without pain. The X-rays did not show signs of mobilization, dislocation, recurrence of infection, or other complications.

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
Sign in / Sign up

Export Citation Format

Share Document