Exploring Acute Kidney Injury Incidence in Hip Periprosthetic Joint Infection Treatment With Combined Intravenous and Intra-articular Antibiotic Infusion

Wenbo Mu, MD, PhD; Boyong Xu, MD; Fei Wang, MD; Wentao Guo, MD, PhD; Xiaogang Zhang, MD; Li Cao, MD

Arthroplasty Today (Feb 2025)

Exploring Acute Kidney Injury Incidence in Hip Periprosthetic Joint Infection Treatment With Combined Intravenous and Intra-articular Antibiotic Infusion

Wenbo Mu, MD, PhD,
Boyong Xu, MD,
Fei Wang, MD,
Wentao Guo, MD, PhD,
Xiaogang Zhang, MD,
Li Cao, MD

Affiliations

Wenbo Mu, MD, PhD: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
Boyong Xu, MD: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
Fei Wang, MD: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
Wentao Guo, MD, PhD: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
Xiaogang Zhang, MD: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
Li Cao, MD: Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Key Laboratory of High Incidence Disease Research in Xingjiang (Xinjiang Medical University), Ministry of Education, Urumqi, Xinjiang, China; Xinjiang Clinical Research Center for Orthopedics, Urumqi, Xinjiang, China; Corresponding author. Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, NO. 137 South Liyushan Road, Urumqi, Xinjiang 830011, China. Tel.: +86 139 099 15960.

Journal volume & issue: Vol. 31
p. 101616

Abstract

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Background: Periprosthetic joint infections (PJIs) are a significant complication following total hip arthroplasty, impacting patient health and healthcare costs. This study examines the incidence of acute kidney injury (AKI) in patients undergoing hip PJI treatment with a combination of intravenous and intra-articular antibiotic infusion therapies. Methods: A retrospective review of 151 patient records from May 1, 2010 to December 30, 2022 was conducted at a single academic hospital. Patients were treated for hip PJIs using debridement, antibiotics, and implant retention or single-stage revision surgeries. AKI was classified according to the Kidney Disease: Improving Global Outcomes criteria. Results: Among 151 patients, 17 (11.26%) developed AKI, with 13 cases resolving transiently before discharge. The median onset of AKI was on postoperative day 2, with stage I AKI being the most prevalent, accounting for 64.71% of cases. Diabetes and low baseline serum creatinine levels were identified as independent risk factors for AKI, with odds ratios of 9.69 and 1.09, respectively. Conclusions: The combined regimen of intra-articular and intravenous antibiotic infusion appears to have a manageable risk profile regarding AKI. This approach could serve as a viable alternative for PJI management, emphasizing the importance of careful patient monitoring and tailored antibiotic regimens. Further studies are recommended to optimize treatment protocols and mitigate risks.

Published in Arthroplasty Today

ISSN: 2352-3441 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://www.journals.elsevier.com/arthroplasty-today/

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