Journal
JOURNAL OF ARTHROPLASTY
Volume 29, Issue 3, Pages 564-568Publisher
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2013.08.017
Keywords
vancomycin; knee; arthroplasty; infection; revision
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Funding
- Missouri Bone & Joint Research Foundation
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The purpose of this study was to measure joint and serum levels of vancomycin following intra-articular (IA) or intravenous (IV) administration, and to compare the concentrations achieved in the joint fluid. IA vancomycin was only used to treat revision total knee arthroplasty (TKA) due to infection, while IV vancomycin was used as a prophylactic agent in primary and revision TKA. Both IA and IV vancomycin achieved therapeutic levels in the synovial fluid of the knee, but IA delivery of vancomycin resulted in peak levels that were many orders of magnitude higher, and also resulted in therapeutic serum levels. The half-life of IA-delivered vancomycin was just over three hours, and trough levels remained therapeutic in the joint and in serum for 24 hours after IA injection. (C) 2014 Elsevier Inc. All rights reserved.
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