[Translated article] Vancomycin powder in the prevention of infection in primary knee and hip arthroplasty: Case–control study with 1151 arthroplasties

• Published in: Revista española de cirugía ortopédica y traumatología 2024-07, Vol.68 (4), p.T344-T350
• Main Authors: Paredes-Carnero, X., Vidal-Campos, J., Gómez-Suárez, F., Meijide, H.
• Format: Article
• Language: English
• Subjects: Arthroplasty complications; Artroplastia total cadera; Artroplastia total rodilla; Complicaciones artroplastias; Infección protésica; Prosthetic infection; Total hip arthroplasty; Total knee arthroplasty; Vancomicina en polvo; Vancomycin powder
• ISSN: 1888-4415; 1988-8856
• DOI: 10.1016/j.recot.2024.03.007

Vancomycin powder (VP) has been positively used in spinal surgery to reduce the rate of infections. Hardly any data have been published on hip and knee joint replacement surgery, and its usefulness is questioned. Our objective was to investigate the effectiveness of VP in reducing prosthetic infection and its possible complications. Primary hip (THA) and knee (TKA) arthroplasties were reviewed, performed by five surgeons in one hospital centre, between 2017 and 2018. One gram of VP was used on the implant prior to surgical closure based on the surgeon's preferences. With a 5-year follow-up in which the infection rate and local complications were analysed. One thousand one hundred and fifty-one arthroplasties were performed, 748 were TKA and 403 were THA. Nine patients were diagnosed with prosthetic infection, of which five received VP and four did not (p=0.555). Likewise, another 15 patients suffered wound complications, of which 11 received VP and 4 did not (p=0.412). There were no differences, either, in the rest of the complications depending on the use or not of VP (p=0.101). Likewise, the number of patients who needed reintervention was similar (p=0.999). No systemic complications were detected due to the use of VP. It has not been possible to demonstrate that the use of VP reduces the rates of prosthetic infection in the hip and knee, so we cannot recommend its use. La vancomicina en polvo (VP) ha sido utilizada positivamente en cirugía de raquis para reducir la tasa de infecciones. Apenas se han publicado datos en cirugía de reemplazo articular de cadera y rodilla, estando en entredicho su utilidad. Nuestro objetivo fue investigar la eficacia de la VP en la reducción de la infección protésica, y sus posibles complicaciones. Fueron revisadas artroplastias primarias de cadera (ATC) y rodilla (ATR), intervenidas por 5 cirujanos en un centro hospitalario, entre los años 2017 y 2018. Se usó 1 g de VP sobre el implante previamente al cierre quirúrgico en función de las preferencias del cirujano. Con un seguimiento de 5 años en los que se analizó la tasa de infección y las complicaciones locales. Se intervinieron 1.151 artroplastias, 748 fueron ATR y 403 ATC. Nueve pacientes fueron diagnosticados de infección protésica, de los que 5 recibieron VP y 4 no (p = 0,555). Así mismo, otros 15 pacientes sufrieron complicaciones de la herida, de los que 11 recibieron VP y 4 no (p = 0,412). No hubo diferencias, tampoco, en el resto complicaciones en función del uso