Decreased Incidence of Periprosthetic Joint Infection in Total Hip Arthroplasty with Use of Topical Vancomycin
Background: Periprosthetic joint infections following total hip arthroplasty (THA) can cause significant patient morbidity and carry with them a substantial cost burden to the healthcare system. The purpose of this study was to assess whether the addition of topical vancomycin decreased the inciden...
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| Format: | Article |
| Language: | English |
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Joint Implant Surgery & Research Foundation
2018-10-01
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| Series: | Reconstructive Review |
| Subjects: | |
| Online Access: | https://reconstructivereview.org/ojs/index.php/rr/article/view/201 |
| _version_ | 1818034576328491008 |
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| author | David A Crawford Keith R Berend Joanne B Adams Adolph V Lombardi |
| author_facet | David A Crawford Keith R Berend Joanne B Adams Adolph V Lombardi |
| author_sort | David A Crawford |
| collection | DOAJ |
| description | Background: Periprosthetic joint infections following total hip arthroplasty (THA) can cause significant patient morbidity and carry with them a substantial cost burden to the healthcare system. The purpose of this study was to assess whether the addition of topical vancomycin decreased the incidence of superficial and deep infections after primary total hip arthroplasty?
Methods: We performed a retrospective analysis of patients who underwent primary THA with (1070 hips) and without (815 hips) the use of topical vancomycin. Records were reviewed to determine incidence of PJI. Infections were categorized as deep or superficial. Medical comorbidity data was evaluated for known risk factors including diabetes, rheumatoid arthritis, and BMI. Records were further reviewed to determine surgical approach used and bacterial cause of PJI.
Results: The overall incidence of infection in the control group was 1.47% (12 hips) and significantly decreased to 0.47% (5 hips) with the addition of topical vancomycin (p=0.022). Deep infections also decreased from 0.86% (7 hips) in the control group to 0.09% (1 hip) in the vancomycin group (p=0.011). There was no difference in BMI or percent of patients with diabetes between groups. In all patients, regardless of vancomycin use, the incidence of infection in the direct lateral approach was higher (2.04%, 9 hips) than the anterior approach (0.055%, 8 hips) (p=0.004).
Conclusions: We found a lower incidence of periprosthetic joint infection after THA with the addition of topical vancomycin. We also found a decreased incidence of infection in patients who had surgery through an anterior approach compared with those who had a direct lateral approach. |
| first_indexed | 2024-12-10T06:41:21Z |
| format | Article |
| id | doaj.art-6be176146ff7427faacc725bc0341a62 |
| institution | Directory Open Access Journal |
| issn | 2331-2262 2331-2270 |
| language | English |
| last_indexed | 2024-12-10T06:41:21Z |
| publishDate | 2018-10-01 |
| publisher | Joint Implant Surgery & Research Foundation |
| record_format | Article |
| series | Reconstructive Review |
| spelling | doaj.art-6be176146ff7427faacc725bc0341a622022-12-22T01:58:46ZengJoint Implant Surgery & Research FoundationReconstructive Review2331-22622331-22702018-10-018110.15438/rr.8.1.201175Decreased Incidence of Periprosthetic Joint Infection in Total Hip Arthroplasty with Use of Topical VancomycinDavid A Crawford0Keith R Berend1Joanne B Adams2Adolph V Lombardi3Joint Implant Surgeons, IncJoint Implant Surgeons, IncJoint Implant Surgeons, IncJoint Implant Surgeons, IncBackground: Periprosthetic joint infections following total hip arthroplasty (THA) can cause significant patient morbidity and carry with them a substantial cost burden to the healthcare system. The purpose of this study was to assess whether the addition of topical vancomycin decreased the incidence of superficial and deep infections after primary total hip arthroplasty? Methods: We performed a retrospective analysis of patients who underwent primary THA with (1070 hips) and without (815 hips) the use of topical vancomycin. Records were reviewed to determine incidence of PJI. Infections were categorized as deep or superficial. Medical comorbidity data was evaluated for known risk factors including diabetes, rheumatoid arthritis, and BMI. Records were further reviewed to determine surgical approach used and bacterial cause of PJI. Results: The overall incidence of infection in the control group was 1.47% (12 hips) and significantly decreased to 0.47% (5 hips) with the addition of topical vancomycin (p=0.022). Deep infections also decreased from 0.86% (7 hips) in the control group to 0.09% (1 hip) in the vancomycin group (p=0.011). There was no difference in BMI or percent of patients with diabetes between groups. In all patients, regardless of vancomycin use, the incidence of infection in the direct lateral approach was higher (2.04%, 9 hips) than the anterior approach (0.055%, 8 hips) (p=0.004). Conclusions: We found a lower incidence of periprosthetic joint infection after THA with the addition of topical vancomycin. We also found a decreased incidence of infection in patients who had surgery through an anterior approach compared with those who had a direct lateral approach.https://reconstructivereview.org/ojs/index.php/rr/article/view/201total hipinfectionvancomycinantibioticarthroplasty |
| spellingShingle | David A Crawford Keith R Berend Joanne B Adams Adolph V Lombardi Decreased Incidence of Periprosthetic Joint Infection in Total Hip Arthroplasty with Use of Topical Vancomycin Reconstructive Review total hip infection vancomycin antibiotic arthroplasty |
| title | Decreased Incidence of Periprosthetic Joint Infection in Total Hip Arthroplasty with Use of Topical Vancomycin |
| title_full | Decreased Incidence of Periprosthetic Joint Infection in Total Hip Arthroplasty with Use of Topical Vancomycin |
| title_fullStr | Decreased Incidence of Periprosthetic Joint Infection in Total Hip Arthroplasty with Use of Topical Vancomycin |
| title_full_unstemmed | Decreased Incidence of Periprosthetic Joint Infection in Total Hip Arthroplasty with Use of Topical Vancomycin |
| title_short | Decreased Incidence of Periprosthetic Joint Infection in Total Hip Arthroplasty with Use of Topical Vancomycin |
| title_sort | decreased incidence of periprosthetic joint infection in total hip arthroplasty with use of topical vancomycin |
| topic | total hip infection vancomycin antibiotic arthroplasty |
| url | https://reconstructivereview.org/ojs/index.php/rr/article/view/201 |
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