A systematic review and meta-analysis comparing intrawound vancomycin powder and povidone iodine lavage in the prevention of periprosthetic joint infection of hip and knee arthroplasties

被引:7
|
作者
Martin, Vidmi Taolam [1 ]
Zhang, Yan [2 ]
Wang, Zhaozhen [3 ,4 ]
Liu, Qiao-Lan [1 ]
Yu, Bo [1 ]
机构
[1] Southern Med Univ, Zhujiang Hosp, Dept Orthopaed & Traumatol, Guangzhou 510282, Peoples R China
[2] Leping Peoples Hosp, Dept Orthopaed, Jingdezhen 333300, Jiangxi, Peoples R China
[3] Jinan Univ, Affiliated Hosp 1, Inst Biol & Med Engn, Guangdong Acad Sci,Dept Bone & Joint Surg, Guangzhou 510632, Peoples R China
[4] Jinan Univ, Affiliated Hosp 1, Inst Biol & Med Engn, Guangdong Acad Sci,Sports Med Ctr, Guangzhou 510632, Peoples R China
关键词
Intrawound vancomycin powder; Total hip arthroplasty; Total knee arthroplasty; Periprosthetic joint infection;
D O I
10.1016/j.jos.2022.11.013
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Focus on reviewing a vigorous research effort to improve the safety profile of vancomycin powder (VP) and its optimal dose in reducing periprosthetic joint infection (PJI) is the need of the hour. This systematic review and meta-analysis attempt to explore the ongoing use of VP and VP + povidone iodine (PI) lavage to prevent PJI of hip/knee arthroplasties and highlights its challenges among the orthopedic community about the existence of the major organism and its frequency in total joint arthroplasty (TJA) patients. Methods: We searched PubMed/MEDLINE, EMBASE databases regarding the outcomes of vancomycin powder (VP) and VP + povidone iodine (PI) combination in preventing periprosthetic joint infection of hip and knee arthroplasties. Results: In 5 of 7 studies, the combination of vancomycin powder (VP) and povidone iodine (PI) lavage have shown a lower risk of periprosthetic joint infection (PJI) in acute and high-risk hip and knee arthroplasties patients, with less or without serious adverse events and readmissions; while four of seven studies using VP-only found increasing rates of PJI in primary total knee arthroplasty and partial hip replacement in elderly patients with comorbidities, and significantly causes aseptic wound complications compared to the control group. Conclusions: Intra-articular vancomycin powder (VP) and povidone iodine (PI) lavage showed a significant reduction of periprosthetic joint infection in primary and revision total joint arthroplasty. Before its widespread use in clinical settings, prospective randomized studies and, most importantly, its long-term efficacy and safety are recommended. (c) 2022 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:165 / 176
页数:12
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