Extended Antibiotic Use in Total Knee Arthroplasty Is Not Associated With Decreased Periprosthetic Joint Infection...

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention
• Clinical Trials

Background:

• Prophylactic antibiotics are crucial for preventing periprosthetic joint infection (PJI) after total knee arthroplasty (TKA).
• Optimal duration of antibiotic prophylaxis in TKA remains debated due to limitations in existing research.
• This study investigates the impact of prophylactic antibiotic duration on TKA PJI rates.

Purpose of the Study:

• To determine if extended duration of prophylactic antibiotics impacts PJI rates in TKA patients.
• To compare PJI incidence between standard (≤24 hours) and extended (>24 hours) antibiotic regimens.
• To evaluate clinical outcomes and patient satisfaction at two-year follow-up.

Main Methods:

• Retrospective analysis of registry data from 17,223 TKAs performed between 2000 and 2018.
• Patients were categorized based on standard or extended antibiotic prophylaxis duration.
• PJI rates, clinical outcomes (Oxford Knee Score, SF-36), and satisfaction were assessed.

Main Results:

• A total of 68 (0.39%) PJI cases were identified; 61 in the standard group and seven in the extended group (P=0.67).
• Extended antibiotic use did not reduce PJI rates in high-risk patients.
• No significant differences in outcome measures or satisfaction were observed at two years.

Conclusions:

• Extended prophylactic antibiotic administration in TKA is not associated with lower PJI rates in the general or high-risk population.
• Routine use of extended-course antibiotics for TKA prophylaxis should be reconsidered.
• Further research is needed to identify specific high-risk patient subgroups who might benefit from extended prophylaxis.