Role of intra-wound powdered vancomycin in primary total knee arthroplasty - 04/04/20

Doi : 10.1016/j.otsr.2020.01.007

Xinxian Xu ^a, Xue Zhang ^b, Yu Zhang ^a, Chengwang Chen ^a, Huachen Yu ^a, Enxing Xue ^a,⁎
^a The Osteopathy Department, the Second Affiliated Hospital and Yuying Children^'s Hospital of Wenzhou Medical University, Wenzhou, China
^b The Department of Operation room, the Second Affiliated Hospital and Yuying Children^'s Hospital of Wenzhou Medical University, Wenzhou, China

^⁎Corresponding author at: The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhou, Zhejiang ProvinceChina

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 04 April 2020
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Abstract

Background

No study has evaluated the effect of topical powdered vancomycin in patients undergoing primary total knee arthroplasty (TKA). The goal of this study is to determine if this method reduces postoperative infection rates following primary TKA.

Patients and methods

This retrospective study reviewed 855 consecutive patients undergoing TKA. The first 418 patients, who did not receive topical vancomycin, were grouped into the control group and the subsequent 437 patients, who received powdered vancomycin applied to the target joint prior to wound closure, were grouped into the treatment group.

Results

The control group was found to have 18 infectious complications (4.3%) compared with 6 (1.4%) in the treatment group, which differed significantly (p<0.05). When comparing the rates of infectious complications independently, there was no significant difference in the rate of superficial infection (3.1% vs. 1.4%; p>0.05), while the difference in prevalence of periprosthetic joint infection (PJI) was statistically significant (1.2% vs. 0; p<0.05). No serious adverse events (AEs) occurred.

Discussion

Topical application of powdered vancomycin may present a reasonable means of decreasing the risk of infectious complications following TKA. There were no serious AEs associated with topical vancomycin. Further research is needed to focus on its long-term efficacy and safety.

Level of evidence

III, retrospective, cohort study.

Le texte complet de cet article est disponible en PDF.

Keywords : Topical powdered vancomycin, Periprosthetic joint infection (PJI), Total knee arthroplasty (TKA), Wound complications, Superficial infection