Acute kidney failure after total knee arthroplasty revision with antibiotic-impregnated cement spacer.
2-stage revision
Acute renal failure
Cement spacer
Gentamicin-impregnated bone–cement
Knee
Knee arthroplasty
Journal
Orthopedic reviews
ISSN: 2035-8237
Titre abrégé: Orthop Rev (Pavia)
Pays: United States
ID NLM: 101524779
Informations de publication
Date de publication:
06 Aug 2020
06 Aug 2020
Historique:
received:
14
03
2020
accepted:
01
05
2020
entrez:
14
9
2020
pubmed:
15
9
2020
medline:
15
9
2020
Statut:
epublish
Résumé
Gentamicin-impregnated cement beads and spacers are frequently used in case of infective complications after Total Knee Arthroplasty (TKA). A great number of studies in the literature demonstrated that the local administration of gentamicin produces high local antibiotic levels but low serum and urine gentamicin concentrations. Gentamicin-impregnated cement spacer can induce nephrotoxicity in patients presenting major renal impairment susceptibility. We report a case of acute renal failure using a gentamicin-impregnated block spacer. An 83-year-old woman underwent a gentamicinimpregnated bone-cement spacer implant because of an infected TKA removal. Three days later patient clinical status got worse reporting a decreased urine output and increasing C-reactive protein (CRP), Serum Creatinine (SCr) and Blood Urea Nitrogen (BUN). Because the symptoms could be related to the knee spacer lead us to the decision of gentamicin-impregnated cement spacer removal. The day following the removal procedure showed progressive improvement of general condition with evidence of SCr and BUN normalization. Gentamicin-impregnated cement spacer can induce nephrotoxicity in patients presenting major renal impairment susceptibility.
Identifiants
pubmed: 32922700
doi: 10.4081/or.2020.8540
pmc: PMC7461639
doi:
Types de publication
Journal Article
Langues
eng
Pagination
8540Informations de copyright
©Copyright: the Author(s).
Déclaration de conflit d'intérêts
Conflict of interest: The authors declare no conflict of interest.
Références
J Arthroplasty. 2007 Jun;22(4 Suppl 1):50-5
pubmed: 17570278
J Bone Joint Surg Br. 1986 Mar;68(2):289-91
pubmed: 3958017
Clin Orthop Relat Res. 2004 Oct;(427):47-51
pubmed: 15552135
Pharmacotherapy. 2005 Jun;25(6):876-80
pubmed: 15927906
Clin Orthop Relat Res. 1994 Dec;(309):44-55
pubmed: 7994976
J Arthroplasty. 2020 Apr;35(4):971-975
pubmed: 31870581
Anesth Analg. 2011 Jun;112(6):1375-81
pubmed: 20807976
J Bone Joint Surg Br. 1992 Jan;74(1):78-82
pubmed: 1732271
Clin Orthop Relat Res. 2002 Nov;(404):132-8
pubmed: 12439251
Chirurg. 1970 Nov;41(11):511-5
pubmed: 5487941
J Arthroplasty. 2012 Jun;27(6):1221-7.e1-2
pubmed: 22321301
J Antimicrob Chemother. 1997 Jun;39(6):677-86
pubmed: 9222035
Int Urol Nephrol. 2019 Jan;51(1):147-153
pubmed: 30324577
J Arthroplasty. 2002 Oct;17(7):948-50
pubmed: 12375257
Clin Pharmacokinet. 1989 Oct;17(4):291-7
pubmed: 2591139
J Bone Joint Surg Am. 1982 Apr;64(4):525-35
pubmed: 7068695
Ann Pharmacother. 2006 Nov;40(11):2037-42
pubmed: 17032907
Clin Orthop Relat Res. 2000 Nov;(380):9-16
pubmed: 11064968