Acute Kidney Injury Following Failed Total Hip and Knee Arthroplasty

The Journal of Arthroplasty
Anju YadavEdward J Filippone

Abstract

Acute kidney injury (AKI) can complicate primary total joint arthroplasty (TJA) of the hip and knee, although the incidence of AKI following revision TJA including prosthetic joint infection (PJI) is poorly defined. We assessed the incidence and risk factors for AKI following revision TJA including surgical treatment of PJI with placement of an antibiotic-loaded cement (ALC) spacer. We retrospectively reviewed 3218 consecutive failed TJAs. Patients with aseptic failure were compared to those with PJI. AKI was determined by RIFLE creatinine criteria. PJIs treated with placement of ALC were compared to PJIs without. Risk factors for AKI were determined by multivariable analysis within the whole group and within those with PJI. AKI developed in 3.4% of 2147 patients revised for aseptic reasons and in 45% of 281 with PJI, including 29% of 197 receiving an ALC and 82% of 84 patients treated with other procedures. By multivariable analysis, age, surgery for PJI, total number of surgeries, and estimated GFR 60-90 compared to >90 cc/min/1.73 m2 were significantly associated with AKI in the whole cohort. Among PJI patients, age, Charlson comorbidity index, and reimplantation surgery were associated with AKI by multivariable analysis. No...Continue Reading

Citations

Jan 13, 2019·Journal of Clinical Medicine·Charat ThongprayoonWisit Cheungpasitporn
Sep 8, 2020·The Journal of Arthroplasty·Christoph TheilBurkhard Moellenbeck
May 3, 2021·The Journal of Arthroplasty·Louis DagneauxMatthew P Abdel
Apr 19, 2021·Acta Anaesthesiologica Scandinavica·Okke NikkinenMerja Vakkala

❮ Previous
Next ❯

Related Concepts

Related Feeds