Prevention of Bacterial Infection after Knee Arthroplasty: a Randomized Control Trial

Abstract

Aim: To assess the efficacy of an absorbable calcium-hydroxyapatite (HAC) coating applied to the articular surface of prosthetic implants, in combination with vancomycin, following non-cemented total knee replacement (TKA). Study Design: Randomized control trial Place and duration: This study was conducted at Muhammad Medical College and Hospital Mirpurkhas, Pakistan from June 2020 to June 2021 Methodology: The 126 patients were split into two groups and each received a total of 135 noncemented TKAs. Knees in Group 1 had non-cemented implants put in without any kind of anti-infection care. The local anti-infection treatment, a pasty combination of 2 g absorbable Hac and 1–2 g vancomycin, was applied to 62 knees in Group 2. On the articular surface of the implants, a thin coating of the paste was applied. Both groups of patients got systemic antibiotic treatment. Results: Although there was no case of loosening, three deep infections occurred in group 1 (which did not get a local anti-infection treatment), which was 4.1 percent, in the early or intermediate postoperative phase. Arthroscopic debridement and antibiotics were utilized to treat the infection. No infections or joint laxity were seen in group 2. Conclusion: In non-cemented TKA patients, our research found that a local anti-infection therapy may be a useful addition to systemic antibiotic therapy in preventing deep infections. Keywords: bacterial infection, prevention, knee replacement.