Acute Renal Failure due to a Tobramycin and Vancomycin Spacer in Revision Two-Staged Knee Arthroplasty
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 remo...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2018/6579894 |
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| author | Ronak A. Patel Hayden P. Baker Sara B. Smith |
| author_facet | Ronak A. Patel Hayden P. Baker Sara B. Smith |
| author_sort | Ronak A. Patel |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-97ad7fdec0384fe09c258dd42515f2aa |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-97ad7fdec0384fe09c258dd42515f2aa2025-02-03T01:24:30ZengWileyCase Reports in Nephrology2090-66412090-665X2018-01-01201810.1155/2018/65798946579894Acute Renal Failure due to a Tobramycin and Vancomycin Spacer in Revision Two-Staged Knee ArthroplastyRonak A. Patel0Hayden P. Baker1Sara B. Smith2College of Medicine, University of Illinois at Chicago, Chicago, IL, USACollege of Medicine, University of Illinois at Chicago, Chicago, IL, USACollege of Medicine, University of Illinois at Chicago, Chicago, IL, USATwo-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.http://dx.doi.org/10.1155/2018/6579894 |
| spellingShingle | Ronak A. Patel Hayden P. Baker Sara B. Smith Acute Renal Failure due to a Tobramycin and Vancomycin Spacer in Revision Two-Staged Knee Arthroplasty Case Reports in Nephrology |
| title | Acute Renal Failure due to a Tobramycin and Vancomycin Spacer in Revision Two-Staged Knee Arthroplasty |
| title_full | Acute Renal Failure due to a Tobramycin and Vancomycin Spacer in Revision Two-Staged Knee Arthroplasty |
| title_fullStr | Acute Renal Failure due to a Tobramycin and Vancomycin Spacer in Revision Two-Staged Knee Arthroplasty |
| title_full_unstemmed | Acute Renal Failure due to a Tobramycin and Vancomycin Spacer in Revision Two-Staged Knee Arthroplasty |
| title_short | Acute Renal Failure due to a Tobramycin and Vancomycin Spacer in Revision Two-Staged Knee Arthroplasty |
| title_sort | acute renal failure due to a tobramycin and vancomycin spacer in revision two staged knee arthroplasty |
| url | http://dx.doi.org/10.1155/2018/6579894 |
| work_keys_str_mv | AT ronakapatel acuterenalfailureduetoatobramycinandvancomycinspacerinrevisiontwostagedkneearthroplasty AT haydenpbaker acuterenalfailureduetoatobramycinandvancomycinspacerinrevisiontwostagedkneearthroplasty AT sarabsmith acuterenalfailureduetoatobramycinandvancomycinspacerinrevisiontwostagedkneearthroplasty |