Clinical outcome evaluation of intraosseous vancomycin in total knee arthroplasty

Harper, Katharine D.; Lambert, Bradley S.; O’Dowd, James; Sullivan, Thomas C.; Incavo, Stephen J.

doi:10.1016/j.artd.2020.02.001

Cited by 18 publications

(13 citation statements)

References 22 publications

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“…( 10 ) 22 66 63 RCT New Zealand Primary TKA IO vancomycin (500 mg) + IV cefazolin (2 or 3 g) IV vancomycin (15 mg/kg dose) + IV cefazolin (2 or 3 g) – 6 Harper et al . ( 11 ) 248 67 67 RCS USA Primary and revision TKA IO vancomycin (500 mg) IV vancomycin (15 mg/kg dose) – 3 Klasan et al . ( 5 ) 632 67.7 ± 8.2 68.7 ± 9.2 RCS New Zealand Primary TKA IO vancomycin (500 mg) + IV cefazolin IV cefazolin MSI criteria 3 Park et al ( 3 ) 993 67.43 ± 8.92 66.74 ± 8.87 RCS USA Primary TKA IO vancomycin (500 mg) + IV cefazolin (1 or 2 g) IV vancomycin (15 mg/kg dose) + IV cefazolin (1 or 2 g) MSI criteria 3 …”

Section: Resultsmentioning

confidence: 99%

“…All the five included studies mentioned an infection ( 3 , 4 , 5 , 10 , 11 ). Klasan et al mentioned that two cases of superficial infection occurred ( 5 ), but the specific distribution in the study group was not specified.…”

Section: Resultsmentioning

confidence: 99%

“…3 ). Two studies mentioned superficial infection (one RCT and one retrospective case series) ( 10 , 11 ). Due to the different types of studies in the two studies, we were unable to combine the results.…”

Section: Resultsmentioning

confidence: 99%

“…The results of both studies showed that IO was not effective for superficial infections compared with IV. A total of five studies reported the occurrence of PJI ( 3 , 4 , 5 , 10 , 11 ). Since Chin et al ’s study is RCT and the result of PJI in Klasan et al is double-zero, neither study was included in the calculation of OR.…”

Section: Resultsmentioning

confidence: 99%

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Intraosseous regional prophylactic antibiotics decrease the risk of infection in total knee arthroplasty compared with intravenous antibiotics: a systematic review and meta-analysis

Xiang

Yang

et al. 2023

EFORT Open Reviews

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Purpose Surgical site infection (SSI) is a rare and serious complication of total knee arthroplasty (TKA), which causes a poor prognosis for patients. The purpose of this study was to explore the effect of intraosseous (IO) antibiotics in preventing infection and complications after TKA compared with intravenous (IV) antibiotics and to provide a certain theoretical basis for clinical treatment. Methods The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed, Embase, Ovid, Web of Science, and the Cochrane Central Register of Controlled Trials databases about trials on IO antibiotics (into the proximal tibia before skin incision) to prevent infections in TKA from the respective inception dates to September 30, 2022. The infection occurred within 3 months after surgery. Both researchers individually screened the studies in accordance with the inclusion and exclusion criteria, performed the literature quality evaluation and data extraction, and used Stata 17 software for data analysis. Results Five studies that enrolled 3801 patients were included in this meta-analysis. The results showed that IO antibiotics were effective in reducing the incidence of SSI (OR: 0.25, P = 0.001) and periprosthetic joint infections (OR: 0.16, P = 0.004) relative to IV. Moreover, the percentage of infection due to Gram-positive bacteria (OR: 0.18, P = 0.025) was reduced in the IO group compared with that in IV group, but Gram-negative bacteria levels were not significantly reduced (P = 0.14). There was no difference between the two groups for other systemic adverse effects of the drug. Conclusions IO antibiotics in TKA are safe and effective alternatives to IV antibiotics. Large randomized clinical studies comparing infection rates and related complications with IO and IV antibiotics are required.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Intraosseous regional prophylactic antibiotics decrease the risk of infection in total knee arthroplasty compared with intravenous antibiotics: a systematic review and meta-analysis

Xiang

Yang

et al. 2023

EFORT Open Reviews

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“…Moreover, it can reduce the time in obtaining vascular access. [ 25 – 27 ] The use of emergency pharmacotherapy administration via the IO route as a first-line approach for vascular access is becoming well-known in clinical settings. However, previous studies did not validate the importance of the adrenaline delivery route.…”

Section: Discussionmentioning

confidence: 99%

Intravenous vs intraosseous adrenaline administration in cardiac arrest

Zhang¹,

Liu²,

Yu³

et al. 2020

Medicine

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Introduction: Cardiac arrest refers to the sudden termination of cardiac ejection function due to various causes. Adrenaline is an important component of resuscitation among individuals experiencing cardiac arrest. The adrenaline delivery method chiefly involved intraosseous infusion and intravenous access. However, the impact of different adrenaline delivery methods on cardiac arrest has been unclear in previous research. Thus, the present study aimed to synthesize the available evidence regarding intravenous vs intraosseous adrenaline administration in cardiac arrest. Methods and analysis: We will search PubMed, EMBASE, Cochrane Library, Wanfang, and China National Knowledge Infrastructure. As per the inclusion criteria, randomized controlled trials (RCTs) on adrenaline administration in cardiac arrest were selected. The primary outcome was prehospital restoration of spontaneous circulation (ROSC); the secondary endpoints were survival, favorable neurological outcome at discharge, and poor neurological outcome at ≥3 mon. We plan to use the Cochrane Collaboration's tool for assessing the bias risk for RCTs. The Grading of Recommendations Assessment, Development and Evaluation approach will grade the certainty of the evidence for all the outcome measures across studies. RevMan 5.3.5 will be used for meta-analysis. If the heterogeneity tests show slight or no statistical heterogeneity, the fixed effects model will be used, in other cases, the random effect model will be used for data synthesis. Results and conclusion: This protocol will determine which epinephrine delivery method is the optimal in the management of cardiac arrest. Our findings will help clinicians and health professionals in making accurate clinical decisions about adrenaline administrations in cardiac arrest. Ethics and dissemination: Ethical approval was not required because this study was planned as a secondary analysis. The results will be disseminated in peer-reviewed publications, journals, and academic. INPLASY registration number: INPLASY202090100 (DOI:10.37766/inplasy2020.9.0100).

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