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J Arthroplasty. 2012 Jun;27(6):1221-7.e1-2. doi: 10.1016/j.arth.2011.12.005. Epub 2012 Feb 7.

Acute kidney injury after placement of an antibiotic-impregnated cement spacer during revision total knee arthroplasty.

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Department of Orthopaedic Surgery, Vanderbilt University School of Medicine, MCE South Tower, Nashville, Tennessee 37232-8774, USA.


We performed a retrospective cohort study of 84 patients to determine the incidence and predictors of acute kidney injury after antibiotic-impregnated cement spacer (ACS) placement for infected total knee arthroplasties. Acute kidney injury was defined as a more than 50% rise in serum creatinine from a preoperative baseline to a level greater than 1.4 mg/dL within 90 days postoperatively. Total incidence was 17% (n = 14; 95% confidence interval [CI], 10%-26%), and acute kidney injury was significantly associated with ACS tobramycin dose as both a dichotomous variable (>4.8 g; odds ratio, 5.87; 95% CI, 1.43-24.19; P = .01) and linear variable (odds ratio, 1.24 for every 1-g increase; 95% CI, 1.00-1.52; P = .049). Routine monitoring of serum creatinine and measurement of serum aminoglycoside levels in response to a threshold creatinine rise may be warranted after the placement of an aminoglycoside-containing ACS.

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