Orthopaedic Joint Infections: Intra-articular Antibiotics


- Discussion: 
    - properties of antibiotics to cementproperties of vancomycin in cement
    - THR infections / - TKR Infections
    - septic arthritis
    - specific organisms:
            - gram negative bacilli: - gram negative cocci: - gram positive bacilli: - gram positive cocci


 - Technique and Dosing:
    - surgical reimplantation is carried out in the usual manner;
    - hickman catheter is tunneled from the joint to the outer skin (catheter cuff is left just beneath the dermis);
    - the intra-articular dose of vancomycin is adjusted to meet optimal serum levels;
    - initial dose is 500 mg in 10 cc NS infused twice daily;
    - be aware that vancomycin can precipitate at high concentrations when mixed with small amounts of cephalosporins and clindamycin;

- human papers:
           - A simple method of intra-articular antibiotic delivery in infected hip arthroplasty.
           - Direct exchange treatment of septic total joint arthroplasty with intra-articular infusion of antibiotics: technique and early results.
           - Methicillin-resistant Staphylococcus aureus in TKA treated with revision and direct intra-articular antibiotic infusion.
           - Use of Hickman Catheters for Intraarticular Administration of Antibiotics
           - Methicillin-resistant Staphylococcus aureus in TKA Treated With Revision and Direct Intraarticular Antibiotic Infusion 
           - Two-Stage Exchange for Infected TKA—Opposes
           - High-dose antibiotic infusion for infected knee prosthesis without implant removal 
           -
Reinfected Revised TKA Resolves With an Aggressive Protocol and Antibiotic Infusion 

    - animal papers: 
           - Intra-articular administration of doxycycline in calves
           - Comparison of intraosseous or intravenous infusion for delivery of amikacin sulfate to the tibiotarsal joint of horses
           - How to Treat Septic Joints with Constant Intra-articular Infusion of Gentamicin or Amikacin
           - Effects of continuous intra-articular infusion of gentamicin on synovial membrane and articular cartilage in the tarsocrural joint of horses.
           - Septic Joint Treatment with Constant Intra-articular Infusion of Gentamicin or Amikacin



The management of chronic osteomyelitis using the Lautenbach method




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, November 27, 2012 2:08 pm