Abstract
Periprosthetic joint infection (PJI) is a devasting complication following total knee replacement (TKA) surgery. While systemic prophylactic antibiotics have been shown to reduce the incidence of infection, their use is limited by dose-dependent toxicity to major organs. As an alternative, prophylactic antibiotics can also be administered locally or regionally. In this chapter, we profile the technique of intraosseous regional administration (IORA). IORA has been found to produce significantly higher tissue concentrations of cefazolin and vancomycin than systemic administration. Other methods of delivering local antibiotics for prophylaxis (such as in wound application of vancomycin powder) are reviewed in this chapter. Local antibiotic delivery methods can also be used as an adjunct therapy for the treatment of established PJIs. This chapter reviews the efficacy and safety of such methods when used as a supplement to debridement, antibiotics, and implant retention (DAIR).
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Holland, S., Young, S.W. (2022). Local Delivery of Antibiotics. In: Hansen, E., Kühn, KD. (eds) Essentials of Cemented Knee Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63113-3_58
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