Renal Failure After Placement of an Articulating, Antibiotic Impregnated Polymethylmethacrlyate Hip Spacer

Overview

Journal Arthroplast Today

Publisher Elsevier

Date 2018 Mar 22

PMID 29560396

Citations 1

Authors

Robert P Runner

Amanda Mener

Thomas L Bradbury

Affiliations

Soon will be listed here.

Abstract

A 58-year-old male presented with native joint septic arthritis of the hip and osteomyelitis. After treatment with an articulating antibiotic spacer, he developed acute renal failure requiring dialysis. He continued to have elevated serum tobramycin levels exclusively from the antibiotic spacer elution as no intravenous tobramycin was used. Subsequent explantation was required to correct his renal failure. Although renal failure after antibiotic impregnated cement placement is rare, the risk of this potential complication should be considered preoperatively and in the postoperative management of these patients.

Citing Articles

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Pargas C, Elhessy A, Abouei M, Gesheff M, Conway J Antibiotics (Basel). 2022; 11(3).

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References

Hanssen A, Spangehl M . Practical applications of antibiotic-loaded bone cement for treatment of infected joint replacements. Clin Orthop Relat Res. 2004; (427):79-85. DOI: 10.1097/01.blo.0000143806.72379.7d. View

Patrick B, Rivey M, Allington D . Acute renal failure associated with vancomycin- and tobramycin-laden cement in total hip arthroplasty. Ann Pharmacother. 2006; 40(11):2037-42. DOI: 10.1345/aph.1H173. View

Li S, Cassidy C, Chang C, Gharib S, Torres J . Diagnostic utility of laboratory tests in septic arthritis. Emerg Med J. 2007; 24(2):75-7. PMC: 2658211. DOI: 10.1136/emj.2006.037929. View

Dovas S, Liakopoulos V, Papatheodorou L, Chronopoulou I, Papavasiliou V, Atmatzidis E . Acute renal failure after antibiotic-impregnated bone cement treatment of an infected total knee arthroplasty. Clin Nephrol. 2008; 69(3):207-12. DOI: 10.5414/cnp69207. View

Rotschafer J, Gilliland S, Rodvold K, FitzGerald C, Guay D . A comparative assessment of vancomycin-associated nephrotoxicity in the young versus the elderly hospitalized patient. J Antimicrob Chemother. 1994; 33(4):811-21. DOI: 10.1093/jac/33.4.811. View

Eder L, Zisman D, Rozenbaum M, Rosner I . Clinical features and aetiology of septic arthritis in northern Israel. Rheumatology (Oxford). 2005; 44(12):1559-63. DOI: 10.1093/rheumatology/kei092. View

Morgan D, Fisher D, Merianos A, Currie B . An 18 year clinical review of septic arthritis from tropical Australia. Epidemiol Infect. 1996; 117(3):423-8. PMC: 2271655. DOI: 10.1017/s0950268800059070. View

Abdelnour A, Arvidson S, Bremell T, Ryden C, Tarkowski A . The accessory gene regulator (agr) controls Staphylococcus aureus virulence in a murine arthritis model. Infect Immun. 1993; 61(9):3879-85. PMC: 281089. DOI: 10.1128/iai.61.9.3879-3885.1993. View

Vrabec G, Stevenson W, Elguizaoui S, Kirsch M, Pinkowski J . What is the Intraarticular Concentration of Tobramycin Using Low-dose Tobramycin Bone Cement in TKA: An In Vivo Analysis?. Clin Orthop Relat Res. 2016; 474(11):2441-2447. PMC: 5052204. DOI: 10.1007/s11999-016-5006-x. View

10.

Gupta M, Sturrock R, Field M . A prospective 2-year study of 75 patients with adult-onset septic arthritis. Rheumatology (Oxford). 2001; 40(1):24-30. DOI: 10.1093/rheumatology/40.1.24. View

11.

Kahlmeter G, Dahlager J . Aminoglycoside toxicity - a review of clinical studies published between 1975 and 1982. J Antimicrob Chemother. 1984; 13 Suppl A:9-22. DOI: 10.1093/jac/13.suppl_a.9. View

12.

Stevens C, Tetsworth K, Calhoun J, Mader J . An articulated antibiotic spacer used for infected total knee arthroplasty: a comparative in vitro elution study of Simplex and Palacos bone cements. J Orthop Res. 2004; 23(1):27-33. DOI: 10.1016/j.orthres.2004.03.003. View

13.

Bertazzoni Minelli E, Benini A, Magnan B, Bartolozzi P . Release of gentamicin and vancomycin from temporary human hip spacers in two-stage revision of infected arthroplasty. J Antimicrob Chemother. 2003; 53(2):329-34. DOI: 10.1093/jac/dkh032. View

14.

Reed E, Johnston J, Severing J, Stevenson K, Deutscher M . Nephrotoxicity Risk Factors and Intravenous Vancomycin Dosing in the Immediate Postoperative Period Following Antibiotic-Impregnated Cement Spacer Placement. Ann Pharmacother. 2014; 48(8):962-969. DOI: 10.1177/1060028014535360. View

15.

Mathews C, Weston V, Jones A, Field M, Coakley G . Bacterial septic arthritis in adults. Lancet. 2010; 375(9717):846-55. DOI: 10.1016/S0140-6736(09)61595-6. View

16.

Jiranek W, Hanssen A, Greenwald A . Antibiotic-loaded bone cement for infection prophylaxis in total joint replacement. J Bone Joint Surg Am. 2006; 88(11):2487-500. DOI: 10.2106/JBJS.E.01126. View

17.

Dubost J, Soubrier M, De Champs C, Ristori J, Bussiere J, Sauvezie B . No changes in the distribution of organisms responsible for septic arthritis over a 20 year period. Ann Rheum Dis. 2002; 61(3):267-9. PMC: 1754020. DOI: 10.1136/ard.61.3.267. View

18.

Torre I . Advances in the management of septic arthritis. Rheum Dis Clin North Am. 2003; 29(1):61-75. DOI: 10.1016/s0889-857x(02)00080-7. View

19.

Ross J . Septic arthritis. Infect Dis Clin North Am. 2005; 19(4):799-817. DOI: 10.1016/j.idc.2005.07.004. View

20.

Tarkowski A . Infection and musculoskeletal conditions: Infectious arthritis. Best Pract Res Clin Rheumatol. 2006; 20(6):1029-44. DOI: 10.1016/j.berh.2006.08.001. View