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No effect of vancomycin powder to prevent infection in primary total knee arthroplasty: a retrospective review of 976 cases

Knee Surgery, Sports Traumatology, Arthroscopy volume 28, pages 3055–3060 (2020)Cite this article

Abstract

Purpose

Vancomycin powder (VP) has been used to prevent periprosthetic joint infection (PJI). However, studies investigating the efficacy of VP to prevent infection in primary total knee arthroplasty (TKA) are very rare. The purpose of this study was to investigate the efficacy of VP application to prevent PJI in TKA.

Methods

Between 2012 and 2016, 976 consecutive patients who underwent primary TKA were included in the present study. Patients were divided into two groups. There were 474 patients (48.6%) in the VP group and 502 patients in the control group (51.4%). Except for VP, all procedures were the same in both groups. In the VP group, 2 g of VP was poured into the joint just before the fascia was closed. Average follow-up was 53.2 months (24–84 months).

Results

Infection was found in 4 (0.84%) of 474 patients in the VP group and 5 (0.99%) of 502 patients in the control group. There was no statistically significant difference between groups in terms of infection rates (p = 0.535). Staphylococcus aureus was found in 2 patients in the VP group. Two patients had S. aureus and 1 patient had Pseudomonas aeruginosa in the control group. There was no statistically significant difference between groups in terms of demographic parameters (p > 0.05).

Conclusion

Intrawound VP administration doesn’t change the infection rates in primary TKA. The VP administration for preventing PJI is not recommended in primary TKA.

Level of evidence

III.

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Acknowledgements

We would like to thank Associate Professor Serdal Kenan Köse from the Ankara University Department of Biostatistics for his help with the statistical analysis.

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Affiliations

  1. Department of Orthopaedics and Traumatology, University of Health Science, Ankara Numune Training and Research Hospital, Ankara, Turkey

    Ibrahim Alper Yavuz, Ozdamar Fuad Oken, Ahmet Ozgur Yildirim, Fatih Inci, Erman Ceyhan & Utku Gurhan

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  1. Ibrahim Alper Yavuz
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  2. Ozdamar Fuad Oken
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Correspondence to Ibrahim Alper Yavuz.

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The authors declare that they have no conflict of interest.

Funding

This study was not externally funded.

Ethical approval

The study was approved by the ethics committee of Ankara Numune Training and Research Hospital (No:2292).

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Yavuz, I.A., Oken, O.F., Yildirim, A.O. et al. No effect of vancomycin powder to prevent infection in primary total knee arthroplasty: a retrospective review of 976 cases. Knee Surg Sports Traumatol Arthrosc 28, 3055–3060 (2020). https://doi.org/10.1007/s00167-019-05778-8

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  • DOI: https://doi.org/10.1007/s00167-019-05778-8

Keywords

  • Local vancomycin powder
  • Primary total knee arthroplasty
  • Total knee replacement
  • Periprosthetic joint infection