title: Acute renal failure after local gentamicin treatment in an infected total knee arthroplasty.
abstract: Local gentamicin treatment in revision surgery for infected hip and knee prostheses is well established. It is a safe and effective method compared with the systemic use of aminoglycosides. Although nephrotoxic side effects are uncommon, we report a case of acute renal failure after 2-stage revision treatment of an infected knee prosthesis with gentamicin-impregnated beads and block spacers. The combined use of beads and a cement block spacer, both gentamicin impregnated, may have induced this severe complication. Use of this procedure in elderly patients warrants careful follow-up of renal function.
authors.affiliation: Department of Orthopaedic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Tom M
authors.initials: TM
authors.lastname: van Raaij
authors.forename: Loes E
authors.initials: LE
authors.lastname: Visser
authors.forename: Arnold G
authors.initials: AG
authors.lastname: Vulto
authors.forename: Jan A N
authors.initials: JA
authors.lastname: Verhaar
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D020370:Osteoarthritis, Knee / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000188:drug therapy*; D012086:Reoperation
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins