Study Summary

33 patients undergoing total shoulder arthroplasty (TSA) were randomized to receive intraosseous (IO) vancomycin or intravenous (IV) vancomycin. The primary outcome of interest was vancomycin tissue concentration in bone and soft tissues during surgery. Secondary outcomes included systemic vancomycin levels and 30 day and 90 day postoperative complications. Outcomes were assessed intraoperatively and through 90 day follow-up. Overall, the results of the study revealed that IO administration achieved similar tissue concentrations to IV administration across all sampled tissues, while significantly reducing systemic vancomycin levels. These findings suggest that IO vancomycin is an effective alternative to IV administration with lower systemic exposure.