Table 1 Descriptive characteristics of eight studies assessing rates of acute kidney injury in first-stage revision arthroplasty involving the use of antibiotic cement spacers
Study | LoE | Country | Age (years) mean (SD) | BMI (kg/m2) mean (SD) | Female (%) | CKD (%) | Pre-op Cr mean (SD) | N (%) | Inclusion criteria | Exclusion criteria | |
|---|---|---|---|---|---|---|---|---|---|---|---|
Hip ACS | Knee ACS | ||||||||||
Aeng [17] | 3 | Canada | 66 (13) | NR | NR | NR | 0.86 (0.79–1.01)* | 32 (64) | 18 (36) | Age > 18, ACS with tobramycin powder + / − vancomycin powder in PMMA cement for first-stage revision of infected TKA/THA | Hemodialysis dependence or development of AKI prior to surgery |
Berliner [18] | 3 | USA | 67 (11) | 31.3 (7.3) | 48 | NR | 0.95 (0.53) | 0 (0) | 75 (100) | Static or articulating ACS for infected TKA | NR |
Dagneaux [19] | 3 | USA | 67 (11) | 33 (8.0) | 47 | 72 (16) | 1.0 (0.5) | 0 (0) | 455 (100) | Chronic PJI following TKA treated with 2-stage exchange involving resection and ACS implantation | Total femoral constructs, bilateral TKA PJI, simultaneous PJI of TKA and another joint, ACS implanted at a different institution, resection only |
Dagneaux [20] | 3 | USA | 65 (12) | 30 (7.0) | 45 | 41 (16) | 1.0 (0.3) | 256 (100) | 0 (0) | Chronic PJI following THA treated with 2-stage exchange involving resection arthroplasty and ACS implantation | Total femoral constructs, hemiarthroplasties, age < 18, bilateral hip PJI, simultaneous PJI of THA and another joint, ACS placed at different institution, resection only |
Edelstein [21] | 2 | USA | 67 (13) | 32 (9.0) | 41 | NR | 0.9 (0.2) | 17 (46) | 20 (54) | Infected primary TKA/THA treated with two-stage exchange involving resection arthroplasty and placement of ACS | Vancomycin/aminoglycoside allergy, no baseline Cr data, repeat spacer exchange required prior to second stage of revision, parenteral aminoglycoside given to reduce AKI risk unrelated to ACS |
Geller [22] | 3 | USA | 64 (12) | 30 (7.0) | 52 | NR | 1.0 (0.7) | 91 (37) | 156 (63) | Hip or knee PJI treated with two-stage revision procedure | Missing information on antibiotic type/dosage in ACS, missing preoperative Cr or postoperative hemoglobin |
Menge [23] | 3 | USA | 63* (NR) | NR | 55 | NR | 0.9 (0.8–1.2)* | 0 | 84 (100) | TKA resection and ACS placement, Cr value < 30 days before ACS placement, Cr value available within 90 days after ACS placement | NR |
Theil [24] | 3 | Germany | NR | 29* (NR) | 52 | NR | 0.9 (0.7–1.2)* | 144 (52) | 135 (48) | Chronic PJI following TKA/THA treated with two-stage revision using PMMA ACS. PJI defined based on MSIS 2011 criteria | Single stage revision for early PJI or aseptic revision, reconstruction following tumor resection, no ACS placement in revision, Girdlestone procedures |