Long-term experience of local vancomycin use in low post-art
The use of intrawound vancomycin powder in TKA surgery has shown very disparate results. Furthermore, although the CDC guidelines are generally effective, they are not explicitly designed for post-TKA infections. The authors present a 7-year experience with vancomycin in primary TKA at a high-volume tertiary knee core. In addition, new requirements for identifying suspected superficial post-TKA infections are suggested.

This is a retrospective analysis of primary total knee arthroplasties performed in a tertiary knee center. All patients with follow-up periods of less than 1 year were excluded from the study. Since March 2011, all patients received vancomycin (powder, 1 g) before water-tight closure of the joint capsule. A comparison was made between this group and historical control subjects. Altogether, 2024 patients were included in the study.

--The vancomycin and the control groups included 1710 and 314 cases respectively.
--Patients were mostly women (male to female ratio, 1 to 4), with a mean age of 65.20 (SD = 10.83) years.
--In the vancomycin group, the rate of suspected SII (1.87%) and PJI (0.41%) was significantly lower than the control group.

In conclusion, this experience suggests that using local vancomycin during TKA surgery may be a fair infection prevention measure.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02344-2