Application of different doses of vancomycin bone cement on patients undergoing total knee arthroplasty

Abstract

Objective To investigate the preventive effect of different doses of vancomycin bone cement on postoperative infection in total knee arthroplasty（TKA）. Methods A prospective study was conducted on 128 patients who underwent TKA in the Orthopedics Department of Handan First Hospital from July 2021 to July 2022. They were randomly grouped into a non⁃antibiotic group，a 0.5 g group，a 1 g group，and a 2 g group using a random number table method，with 32 cases in each group. All patients received a standard perioperative infection prevention protocol. The non⁃antibiotic group was treated with bone cement without added antibiotics；the 0.5 g，1 g，and 2 g groups received 40 g bone cement mixed with the corresponding dose of vancomycin，respectively，for the prevention of postoperative infection. The postoperative knee flexion angle，inflammatory indicators［erythrocyte sedimentation rate（ESR），serum C⁃reactive protein（CRP）］，knee joint function［Hospital for Special Surgery（HSS）score］，postoperative infection，and adverse reactions were compared among the four groups. Results The postoperative knee flexion angle of patients in the 0.5 g，1 g，and 2 g groups was greater than that in the non⁃antibiotic group（P0.05）. The concentration of vancomycin in the drainage fluid of patients in the 2 g group was higher than that in the 0.5 g and 1 g groups（P0.05）. At 6 months and 12 months after surgery，the HSS scores of patients in the 0.5 g，1 g，and 2 g vancomycin groups were higher than those in the non⁃antibiotic group（P＜0.05），and there was no statistically difference among the three vancomycin groups（P>0.05）.Within 12 months after surgery，4 patients in the non⁃antibiotic group experienced postoperative infections，while the three vancomycin groups did not experience any postoperative infections. Conclusion Vancomycin bone cement for TKA can reduce patients’inflammation levels，improve knee joint function and control infection. The effects of 0.5 g，1 g，and 2 g vancomycin bone cement are similar