Open AccessIntraosseous Regional Administration of Antibiotic Prophylaxis in Total Knee Arthroplasty
Author(s) -
Jaymeson R. Arthur,
Joshua S. Bingham,
Henry D. Clarke,
Mark J. Spangehl,
Simon W. Young
Publication year - 2020
Publication title -
jbjs essential surgical techniques
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 7
ISSN - 2160-2204
DOI - 10.2106/jbjs.st.20.00001
Subject(s) - medicine , antibiotics , periprosthetic , perioperative , vancomycin , surgery , anesthesia , syringe , antibiotic prophylaxis , arthroplasty , staphylococcus aureus , genetics , psychiatry , bacteria , microbiology and biotechnology , biology
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.