A Revision of an Infected Total Hip Arthroplasty leading to Oxalate Nephropathy: A Case Report

Abstract

Introduction: Although one of the most successful orthopedic procedures, total hip arthroplasty (THA) conveys a not negligible risk for complications.

Case report: A 72-year-old patient after a THA received an operative revision 2 times due to persistent hematoma and early periprothetic infection. Post-operative renal failure requiring hemodialysis has been caused by a histologically confirmed oxalate nephropathy (ON). Post-operative antibiotic treatment altering the gut microbiome has been assumed as the most likely cause of ON. It is the first presented case of ON as a post-operative complication after a hip arthroplasty revising operation.

Conclusion: Acute post-operative renal injury conveys significant danger for the patients. An interdisciplinary approach is needed as many cases require complex diagnostic and therapeutical procedures offered by experts on the field.

Keywords: Total hip arthroplasty; acute renal failure; complication; oxalate nephropathy; total hip arthroplasty.

Figure 1

(a) Pre-operative pelvic a-p X-ray showing the arthrosis of the right hip joint. (b) Post-operative pelvis a-p X-ray depicting the total hip arthroplasty on the right hip joint.

Figure 2

Histological images depicting the micro deposition of oxalate in the renal cortex. The arrow shows the region presented separately in a bigger scale depicting the oxalate depositions in the red square.

Figure 3

A timeline summarizing the presented case. Parts of the figure were drawn by using pictures from Servier Medical Art. Servier Medical Art by Servier is licensed under a Creative Commons Attribution 3.0 Unported License (https://creativecommons.org/licenses/by/3.0/).