Perioperative Antibiotic Utilization by Orthopedic Surgeons in Arthroscopic Surgery A Survey of Practice Patterns

Given the relatively low incidence of infection, the role of prophylactic antibiotics for infection prevention in arthroscopic surgery is unclear. Without established evidence-based guidelines, it becomes important to understand the trends and common practices in the field.

We hypothesized that a majority of surgeons would use preoperative intravenous antibiotics and that postoperative antibiotics would be rarely used.

A web-based link containing a questionnaire on perioperative antibiotic use for arthroscopic surgery of the knee and shoulder was sent to sports medicine surgeons at several institutions in the New York tri-state region. The questionnaire addressed antibiotic use both preoperatively and postoperatively and the type of medication used.

During the study period, 86 surgeons responded to the knee portion of the survey and 139 surgeons responded to the shoulder portion of the survey. A significant majority (94.24% for knee and 93.02% for shoulder) of the respondents routinely preferred to use preoperative intravenous antibiotics for both shoulder and knee surgery. The antibiotic of choice for a majority of the respondents was cefazolin (98.1% respondents). In patients with penicillin allergies, most preferred to use clindamycin. Most respondents (84.5%) did not routinely use postoperative oral antibiotics.

There is significant consensus among orthopedic surgeons performing knee and shoulder arthroscopic surgery regarding use of preoperative antibiotics, with the majority routinely prescribing preoperative intravenous antibiotics for prophylaxis and cefazolin being the most commonly used antibiotic. The majority of surgeons prefer not to use postoperative oral antibiotics.

This study describes the current trends in the use of perioperative antibiotics among orthopedic surgeons for routine arthroscopic procedures in the shoulder and knee.