Mancino F, Yates PJ, Clark B, Jones CW. Use of topical vancomycin powder in total joint arthroplasty: Why the current literature is inconsistent? World J Orthop 2023; 14(8): 589-597 [PMID: 37662663 DOI: 10.5312/wjo.v14.i8.589]
Corresponding Author of This Article
Fabio Mancino, MD, Doctor, Department of Orthopaedics, Fiona Stanley Hospital, 11 Robin Warren, Perth 6150, Australia. fabio_mancino@yahoo.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Aug 18, 2023; 14(8): 589-597 Published online Aug 18, 2023. doi: 10.5312/wjo.v14.i8.589
Use of topical vancomycin powder in total joint arthroplasty: Why the current literature is inconsistent?
Fabio Mancino, Piers J Yates, Benjamin Clark, Christopher W Jones
Fabio Mancino, Piers J Yates, Christopher W Jones, Department of Orthopaedics, Fiona Stanley Hospital, Perth 6150, Australia
Piers J Yates, Christopher W Jones, Department of Orthopaedics, The Orthopaedic Research Foundation of Western Australia, Perth 6010, Australia
Piers J Yates, Department of Orthopaedics, University of Western Australia, Perth 6009, Australia
Benjamin Clark, Department of Infectious Diseases, Fiona Stanley Hospital, Perth 6150, Australia
Christopher W Jones, Department of Orthopaedics, Curtin University, Perth 6102, Australia
Author contributions: Mancino F, Jones CW conceptualization; Yates PJ, Jones CW supervision and validation; Mancino F wrote the original draft; Yates PJ, Jones CW, Clark B, review and editing; and all the authors gave final approval of the version to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabio Mancino, MD, Doctor, Department of Orthopaedics, Fiona Stanley Hospital, 11 Robin Warren, Perth 6150, Australia. fabio_mancino@yahoo.com
Received: December 28, 2022 Peer-review started: December 28, 2022 First decision: February 21, 2023 Revised: March 28, 2023 Accepted: April 20, 2023 Article in press: April 20, 2023 Published online: August 18, 2023 Processing time: 231 Days and 21.7 Hours
Abstract
Periprosthetic joint infection (PJI) is a rare but terrible complication in hip and knee arthroplasty, and the use of topical vancomycin powder (VP) has been investigated as a tool to potentially reduce its incidence. However, there remains no consensus on its efficacy. Therefore, the aim of this review is to provide an overview on the application of topical vancomycin in orthopaedic surgery focusing on the recent evidence and results in total joint arthroplasty. Several systematic reviews and meta-analyses on topical VP in hip and knee arthroplasty have been recently published reporting sometimes conflicting results. Apart from all being limited by the quality of the included studies (mostly level III and IV), confounding variables are often included potentially leading to biased conclusions. If taken into consideration the exclusive use of VP in isolation, the available data, although very limited, suggest that it does not reduce the infection rate in routine primary hip and knee arthroplasty. Therefore, we still cannot advise for a routinary application. A properly powered randomized-controlled trial would be necessary to clarify the role of VP in hip and knee arthroplasty. Based on the analysis of the current evidence, the use of topical VP appears to be safe when used locally in terms of systemic adverse reactions, hence, if proven to be effective, it could bring great benefits due to its low cost and accessibility.
Core Tip: Vancomycin powder is widely used in orthopaedic surgery and it has been recently investigated in total joint arthroplasty (TJA), however, results are often conflicting. The aim of this study was to report on the use of vancomycin powder in orthopaedic surgery focusing on its application in TJA.
