Mohammad Ayati Firoozabadi Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Science, Tehran, Iran Seyed Mohammad Javad Mortazavi Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Science, Tehran, Iran Ali Basim Abdan Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Science, Tehran, Iran

Keywords: Total knee arthroplasty, Prosthetic joint infection, Vancomycin, Ceftazidime

Abstract Background Prosthetic joint infection (PJI) is a very disastrous complication of total knee arthroplasty (TKA). Some studies have considered intra-articular antibiotic injection to be effective in the prevention of PJI, but several articles have the opposite opinion. However, there is no study performed in one center, by one surgeon, one surgical team, or one type of prosthetic device. Methods This study was a historical cohort study on the patients who underwent primary TKA with vancomycin and ceftazidime (652 cases from September 2019 to the end of December 2020) that were compared with a cohort of patients with the same TKA method without antibiotics injection (620 controls, from March 2018 to the end of August 2019). The incidence of PJI was followed for 2 years in each group by chart review. Results Study groups were matched for age (P-value=0.193), gender (P-value=0.913), body mass index (P-value=0.136), and radiologic features of their knees (P-value> 0.05). In the case and control groups, one (0.18%) and two (0.32%) patients had PJI, respectively (P-value=0.615). All patients experiencing PJI were subjected to Debridement, antibiotics, implant retention (DAIR) surgery, and antibiotic therapy which responded to the treatment. Conclusion To our knowledge, this is the most precisely matched cohort of TKA subjects in this era. Intra-articular injection of vancomycin and ceftazidime during total knee arthroplasty in the case group showed no significant difference concerning decreasing PJI risk; while for such a rare event of PJI, a study with even larger sample sizes is needed, prospectively.

How to Cite

Ayati Firoozabadi, M., Mortazavi, S. M. J., & Basim Abdan, A. (2023). Efficacy of intra-articular injection of vancomycin and ceftazidime during total knee arthroplasty: prophylaxis of prosthetic joint infection. Galen Medical Journal, 12, e2976. https://doi.org/10.31661/gmj.v12i.2976

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