The Clinical Study Of Vancomycin Powder In Preventing Periprosthetic Joint Infection After Primary Total Hip Arthroplasty

Objective:To study the effectiveness and safety of vancomycin powder in the total hip arthroplasty for the prevention of periprosthetic joint infection.Methods:In this paper,a retrospective study was performed on 253 patients with THA who were hospitalized from June 2011 to March 2017 in the Department of Orthopaedics,and divided into VP group according to whether the intraoperative incision was treated with vancomycin powder.VP group and control group(without VP).There were 118 patients in the vp group and 135 in the control group.Preoperative management measures,surgical procedures,and postoperative rehabilitation were not specific.In the VP group,approximately 0.3 g of vancomycin was placed in the femoral canal before the femoral stem was installed.About 0.3 g was evenly spread on the acetabular surface of the acetabular prosthesis before the acetabular prosthesis was installed.0.3 g of vancomycin was placed in the joint capsule,and the remaining vancomycin was spread over the sutured muscle layer.Postoperative routine static cephalosporin antibiotics.The mean follow-up time of the control group was 14.4 months(range 3.0 to 34.9 months),and the mean follow-up of the VP group was 17.2 months(range 3.0 to 43.1months).The incidence of postoperative PJI,drug side effects,and incision complications were observed and recorded.Statistical analysis was performed on the relevant values.Results:Observe and record the incidence of postoperative PJI,drug side effects,and incision complications.Statistical analysis was performed on the relevant values.The results showed that 5 cases of PJI(2.28%)and VP group of 0cases(0%).No ototoxicity,renal dysfunction,aseptic loosening,death and allergic reactions were observed in either group.In the control group,2patients with PJI were cured after joint operation,and 2 patients were cured after 1 debridement;1 patient was cured after 3 thorough debridement.Incision complications occurred in 2 patients(1.56%)in the VP group.These wound complications did not meet the PJI criteria and may be secondary to incision hematoma.Staphylococcus is the most common isolate in PJI patients,with 2 cases of MSSA,1 case of MRSA and 1 case of coagulase-negative staphylococci,and 1 case of no bacterial growth.Theincidence of PJI in the two groups was statistically significant(P<0.05).The incidence of complications was compared between the two groups.The incidence of deep infection was higher in the control group,while the incidence of wound complications in the VP group was higher.Similarly,the incidence of wound complications was higher in the VP group compared to the control group.There were no significant differences between the two groups in height,gender,weight,age incision complications,and average length of hospital stay(P>0.05).Conclusion:In the THA operation,the use of vancomycin powder in the femoral cavity,acetabular bone and other prostheses and incisions can reduce the incidence of postoperative PJI,and it is relatively safe,no obvious drug side effects.However,there may be a higher incidence of aseptic incision complications.The efficacy and safety of VP in the THA incision requires more research to prove.