Vancomycin in TKAs

Periprosthetic joint infection (PJI) is a national health crisis and leads to very poor outcomes for patients undergoing elective joint replacement. Within the realm of elective total knee arthroplasty (TKA), various methods of infection prophylaxis are in place. These include sterile precautions, would/tissue handling, and antibiotic prophylaxis. With respect to the latter, various approaches have been utilized including intravenous and intraosseous administration of vancomycin, preoperatively. Intraosseous administration does require another wound and a specific device to administer. The investigators proposed that intraarticular injection of vancomycin is non-inferior to intraosseous administration, thus reducing wounds, time, and cost.

Recruiting

Interested in participating?

Request Info

Key information

Conditions

Total Knee Arthroplasty

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

University of California, San Diego

San Diego, California, 92093, United States

Location status: Recruiting

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Any patient over the age of 18 years of age receiving treatment at UC San Diego Health
Undergoing primary unilateral TKA
Ability to provide consent

Exclusion criteria

previous surgery on the knee (with the exception of arthroscopy)
BMI > 35
contraindication to receiving vancomycin, cefepime or cefazolin (ie, allergy, etc)
diabetics with A1c>7.5% (unless controlled fructosamine)
immunocompromised or immunosuppressed patients (HIV, Hepatitis C, end stage renal disease (ESRD), post transplant, chemotherapy or radiation therapy within 6 months of surgery, immunomodulating meducations)
no history of active infections
no history of chronic kidney disease

Treatment and study plan

Vancomycin

Drug

Intraosseous or Intraarticular administration of Vancomycin

Primary outcomes

Concentration of vancomycin in bone, synovial tissue, subcutaneous fat and serum blood

Time frame: Intraoperative

Interested in participating?

Recruiting

Interested in participating?

Request Info

Sponsors and collaborators

Lead sponsor

University of California, San Diego

Other

Registry information

Official study title

A Prospective, Randomized Parallel Group Study of the Efficacy of Vancomycin Administered Through Intraarticular Injection Versus Intraosseous Injection Versus Intravenous Infusion in Patients Undergoing Total Knee Arthroplasty

Important dates

Study start: 2024
Primary completion: 2026
Study completion: 2028
First posted: Dec 15, 2025
Registry last updated: Jun 3, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Recruiting