SynthesisJournal of orthopaedic surgery and research2023
Acute kidney injury in the context of staged revision arthroplasty and the use of antibiotic-laden cement spacers: a systematic review.
Synthesis in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 7 citations in OpenAlex.
- Antimicrobial-loaded PMMA bone cement: time for good practice recommendations.The Journal of antimicrobial chemotherapy · 2026Article
- Research Progress on Risk Factors for Acute Kidney Injury After Antibiotic-Loaded Bone Cement Spacer Treatment for Periprosthetic Joint Infection.Orthopaedic surgery · 2026Review
- Safety of locally applied antibiotics in orthopaedic trauma surgery: descriptive results from a prospective cohort study.Journal of bone and joint infection · 2026Article
- Significant differences in the rate of periprosthetic joint infections in revision hip and knee arthroplasty depending on the applied definition.Archives of orthopaedic and trauma surgery · 2025Article
- Evaluation and testing of polymethylmetacrylic (PMMA) bone cements with admixed Amphotericin B.Journal of orthopaedic surgery and research · 2025Article
- Risk Factors for Acute Kidney Injury in Patients Undergoing Total Joint Arthroplasty.Reports (MDPI) · 2024Article
- High and Low Dosage of Vancomycin in Polymethylmethacrylate Cements: Efficacy and Mechanical Properties.Antibiotics (Basel, Switzerland) · 2024Article
- Ninety-day postoperative mortality and complications in continuous and unselected single-stage revisions for chronic periprosthetic joint infection.International orthopaedics · 2024Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe most common cause of revision arthroplasty is prosthetic joint infection (PJI). Chronic PJI is commonly treated with two-stage exchange arthroplasty involving the placement of antibiotic-laden cement spacers (ACS) in the first stage, often containing nephrotoxic antibiotics. These patients often have significant comorbidity burdens and have higher rates of acute kidney injury (AKI). This systematic review aims to assess the current literature to identify (1) AKI incidence, (2) associated risk factors, and (3) antibiotic concentration thresholds in ACS that increase AKI risk following first-stage revision arthroplasty.
methodsAn electronic search was performed of the PubMed database of all studies involving patients undergoing ACS placement for chronic PJI. Studies assessing AKI rates and risk factors were screened by two authors independently. Data synthesis was performed when possible. Significant heterogeneity prevented meta-analysis.
resultsEight observational studies consisting of 540 knee PJIs and 943 hip PJIs met inclusion criteria. There were 309 (21%) cases involving AKI. The most commonly reported risk factors included perfusion-related factors (lower preoperative hemoglobin, transfusion requirement, or hypovolemia), older age, increased comorbidity burden, and nonsteroidal anti-inflammatory drug consumption. Only two studies found increased risk with greater ACS antibiotic concentration (> 4 g vancomycin and > 4.8 g tobramycin per spacer in one study, > 3.6 g of vancomycin per batch or > 3.6 g of aminoglycosides per batch in the other); however, these were reported from univariate analyses not accounting for other potential risk factors. DISCUSSION: Patients undergoing ACS placement for chronic PJI are at an increased risk for AKI. Understanding the risk factors may lead to better multidisciplinary care and safer outcomes for chronic PJI patients. LEVEL OF EVIDENCE III:
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