The efficacy of vancomycin powder in total knee arthroplasty

Abstract

Objectives: To assess the efficacy of vancomycin powder (VP) in total knee arthroplasty (TKA). Methods: The study design was retrospective cohort. All patients who underwent primary TKA for osteoarthritis between January 1, 2018, and March 1, 2020, in King Abdulaziz Medical City, Riyadh, Saudi Arabia were included (n=98). Of the total participants, 48 participants in the experimental group matched with 48 participants in the control group were included in the final study sample. Numerical variables are reported as means, standard deviations, and standard errors. The hypothesis was tested using the Chi-square test and independent t-test. Results: In comparison to the control group, intraoperative vancomycin powder (VP) did not decrease surgical site infection risk in the experimental group ( p =0.31). Conclusion: We found no significant differences in the infection rates following primary TKA when using VP.

The effect of different preventive strategies during total joint arthroplasty on surgical site infection: a network meta-analysis

“…The publication years of the included articles ranged from 2008 to 2023. Among them, 8 articles compared ALBC with negative control (NC) [23][24][25][26][27][28][29][30], 9 articles compared chlorhexidine bathing with NC [31][32][33][34][35][36][37][38][39], 4 articles compared povidone iodine lavage with NC [40][41][42][43], and 14 articles compared vancomycin with NC [13,[44][45][46][47][48][49][50][51][52][53][54][55][56]]. In addition, 2 articles compared chlorhexidine and povidone iodine bathing [57,58], and 1 article compared povidone iodine bathing, vancomycin powder and NC [59].…”

Local Application of Vancomycin in Orthopaedic Surgery—A Review

“…This study also concluded that VP should not be used in primary TKA to prevent PJI 19 . In a single center study of 98 patients, Aljuhani et al did not find a significant difference in infection rates after primary TKA when using intrawound VP 24 . In a separate retrospective cohort study of patients undergoing TKA and THA, Matziolis et al found that although a small difference in PJI risk was observed in the group with local vancomycin compared with the control group, it was not statistically significant 25 .…”

“…After primary TKA, the prevalence of periprosthetic joint infection (PJI) according to recent studies is 2% and increases to 5.6% after revision TKA 19 . Some studies have shown reduction in PJI after administering VP in the surgical wound before closure of the capsule [20][21][22] , whereas others have not found a statistically significant benefit 19,23,24 .…”

“…Moreover, Crawford et al in a retrospective study found that the PJI rate in patients receiving topical vancomycin in primary THA to be 0.47% (1,070 patients), compared with 1.47% (815 patients) in the control group, which was statistically significant. [22][23][24][25] Dial et al in a retrospective review of 265 patients undergoing THA reported rates of PJI to be lower in the VP-receiving group compared with the group without local antibiotics (0.7% vs. 5.5%, p 5 0.031) 21 . It is worth mentioning that there was a significant increase in sterile seroma formation that required operative management in patients who received VP when compared with the control group (4.4% vs. 0%, p 5 0.030) 21 .…”

Effectiveness of Intra-Articular Injection of Ceftazidime/Vancomycin Combination during Total Knee Replacement: Prevention of Periprosthetic Joint Infection

“…Postoperative deep wounds are a cause for significant concern, as infections in the surgical site can result in prolonged hospitalization, increased financial burden for the patient and elevated mortality rates (3). Prosthetic joint infection is one of the most dangerous complications of TKA surgery and the most important reason for the revision of TKA (4). Studies have shown that deep infections occur in 1.1% to 1.7% of TKA surgeries (5).…”