Intraosseous vancomycin results in lower superficial and deep infection rate compared with alternative intravenous methods in total knee arthroplasty: a time-stratified meta-analysis.

Resumen del estudio

13 studies involving patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA) were included in this systematic review and meta-analysis comparing intraosseous (IO) vancomycin with intravenous (IV) antibiotic prophylaxis. Of these, 11 studies contributed to the quantitative meta-analysis. Pooled outcomes included periprosthetic joint infection (PJI), tissue antibiotic concentrations, wound complications, revision surgery, reoperation, acute kidney injury (AKI), and deep vein thrombosis (DVT). IO vancomycin was associated with significantly lower PJI rates, fewer Gram-positive infections, fewer wound complications managed non-operatively, and higher local antibiotic concentrations. No significant differences were observed in revision rates, reoperation, AKI, or DVT. These findings suggested that IO vancomycin was an effective and potentially safe alternative to conventional IV prophylaxis for reducing postoperative infections following primary TKA.