Intraosseous Vancomycin in Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

Division

North Texas

Hospital

Medical City Denton

Document Type

Manuscript

Publication Date

12-1-2025

Keywords

Infection, Intraosseous antibiotics, Intraosseous vancomycin, Total knee arthroplasty

Disciplines

Medicine and Health Sciences | Orthopedics | Surgical Procedures, Operative

Abstract

BACKGROUND: Prosthetic joint infections (PJIs) are a major concern in total knee arthroplasty (TKA). One recent measure of interest has been the use of intraosseous vancomycin (IOV). This systematic review aims to evaluate the efficacy of IOV to prevent infection in TKA.

METHODS: A search was conducted across MEDLINE/Pubmed, Wiley Central, Google Scholar, Web of Science, and Embase databases. Demographics and results of the studies were extracted from the articles that met inclusion criteria. Meta-analysis was conducted on primary TKA studies.

RESULTS: Eight studies were included in this systematic review. IOV correlated with decreased odds of infection in primary TKA (odds ratio: 0.31,

CONCLUSIONS: IOV is an effective adjunctive treatment for preventing infection in primary TKA, with this study showing a 69% decreased odds of infection when compared with controls of intravenous antibiotic and no regional IOV. IOV also appears to be a safe treatment, and with limited data there seems to not be an increase in AKI or creatinine concentration.

LEVEL OF EVIDENCE: Level IV; Therapeutic.

Publisher or Conference

Arthroplasty Today

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