Intraosseous Regional Administration of Antibiotic Prophylaxis in Total Knee Arthroplasty.

Journal: JBJS essential surgical techniques
Published Date: Dec 24, 2020

Abstract

BACKGROUND: Periprosthetic joint infection (PJI) is a devastating complication following total knee arthroplasty (TKA), and perioperative antibiotics are commonly administered to try to mitigate the chance of infection. Intraosseous regional administration (IORA) of prophylactic antibiotics during TKA is a method of antibiotic delivery that has been shown to achieve markedly higher tissue concentrations at much lower doses. Other advantages include ease of administration, ability to time the antibiotic delivery with the surgical start time for maximal effectiveness, and less systemic side effects. The concept is similar to a Bier block, except that IORA involves the use of antibiotics instead of local anesthetic to perfuse the limb and is given via intraosseous rather than intravenous access.

Authors

  • Jaymeson R Arthur
    Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona.
  • Joshua S Bingham
    Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona.
  • Henry D Clarke
    Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona.
  • Mark J Spangehl
    Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona.
  • Simon W Young
    Department of Orthopaedic Surgery, University of Auckland, Auckland, New Zealand.

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