Nephrotoxicity After the Treatment of Periprosthetic Joint Infection With Antibiotic-Loaded Cement Spacers

Adam I. Edelstein*, Kamil T. Okroj, Thea Rogers, Craig J. Della Valle, Scott M. Sporer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Background: Treatment of periprosthetic joint infections commonly involves insertion of an antibiotic-loaded cement spacer (ACS). The risk for acute kidney injury (AKI) related to use of antibiotic spacers has not been well defined. We aimed to identify the incidence of and risk factors for AKI after placement of an ACS. Methods: We performed a prospective cohort study of patients with an infected primary total hip or knee arthroplasty treated with ACSs with vancomycin, gentamicin, and tobramycin. Serum creatinine and glomerular filtration rate data were collected at baseline and weekly intervals for 8 weeks. Patients were classified into Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (RIFLE) stages to determine incidence of AKI. Risk factors for kidney injury were identified via regression analysis. Results: A total of 37 patients (20 total knee arthroplasty and 17 total hip arthroplasty) were included. During the 8 weeks after ACS placement, 10 patients (27%) fit RIFLE criteria for kidney injury and 2 patients (5%) fit RIFLE criteria for kidney failure. No baseline patient characteristics were associated with development of AKI. Conclusion: Patients should be monitored closely for development of AKI after placement of ACSs for the treatment of periprosthetic joint infection. Further research into minimizing risk for AKI is warranted.

Original languageEnglish (US)
Pages (from-to)2225-2229
Number of pages5
JournalJournal of Arthroplasty
Issue number7
StatePublished - Jul 2018


  • acute kidney injury
  • antibiotic-loaded cement spacer
  • nephrotoxicity
  • periprosthetic joint infection
  • revision arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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