Abstract
The infection in total joint arthroplasty in most cases is blood borne in origin, but seeding of organisms at the time of surgery is also a well recognised cause. The aim of our study was to determine the optimal timing to administer the prophylactic per-operative antibiotics in total knee arthroplasties performed under tourniquet control.
The patients were randomised in two groups “A” (18 patients), received antibiotics at the time of induction of anaesthesia and group “B” (15 patients), received antibiotics ten minutes prior to the release of tourniquet. We used the intravenous doses of Kafadol 1gm and Gentamicin 160mgs for 24 hours. The antibiotic levels were assessed using blood samples taken from the peripheral vein, operative wound (periprosthetic area) and suction drains. Both groups were well matched with regard to age, weight, sex, ASA class and number of patients.
In group “A” the antibiotic levels were lower in operative wound as compared to the peripheral vein and it continued to decline in the post operative period. In group “B” the levels were 40% higher in the samples from the operative wound and remained significantly high in post operative period, as compared to those in group “A”.
Our findings are in favour of antibiotic administration just before the release of the tourniquet in the total knee arthroplasty.
The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at Irish Orthopaedic Associaton, Secretariat, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11.
