{"title":"Safety and efficacy of combined intra-articular administration of vancomycin and ε-aminocaproic acid in total hip arthroplasty : a clinical study.","authors":"Mingwei Hu, Yifan Zhang, Cuicui Guo, Xue Yang, Hao Xu, Shuai Xiang","doi":"10.1302/0301-620X.107B2.BJJ-2024-0232.R2","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the concurrent use of vancomycin and ε-aminocaproic acid (EACA) in primary total hip arthroplasty (THA).</p><p><strong>Methods: </strong>In total, 120 patients undergoing unilateral primary THA were divided into three groups: Group VE received intra-articular vancomycin and EACA; Group V received only intra-articular vancomycin; and Group E received only intra-articular EACA. Blood and joint fluids were sampled postoperatively to measure the vancomycin levels using chromatography. Blood loss and kidney function were monitored.</p><p><strong>Results: </strong>Groups E and VE had equivalent blood loss, which was less than that in Group V. Intra-articular vancomycin levels were higher in Group VE at all intervals, with similar serum levels across the groups. Acute kidney injury, ototoxicity, and allergies were not observed, nor was a difference in rates of periprosthetic joint infection.</p><p><strong>Conclusion: </strong>Adding intra-articular EACA to vancomycin did not affect intra-articular vancomycin levels, and maintained EACA's antifibrinolytic effects.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 2","pages":"157-163"},"PeriodicalIF":4.9000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bone & Joint Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1302/0301-620X.107B2.BJJ-2024-0232.R2","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: To evaluate the concurrent use of vancomycin and ε-aminocaproic acid (EACA) in primary total hip arthroplasty (THA).
Methods: In total, 120 patients undergoing unilateral primary THA were divided into three groups: Group VE received intra-articular vancomycin and EACA; Group V received only intra-articular vancomycin; and Group E received only intra-articular EACA. Blood and joint fluids were sampled postoperatively to measure the vancomycin levels using chromatography. Blood loss and kidney function were monitored.
Results: Groups E and VE had equivalent blood loss, which was less than that in Group V. Intra-articular vancomycin levels were higher in Group VE at all intervals, with similar serum levels across the groups. Acute kidney injury, ototoxicity, and allergies were not observed, nor was a difference in rates of periprosthetic joint infection.
Conclusion: Adding intra-articular EACA to vancomycin did not affect intra-articular vancomycin levels, and maintained EACA's antifibrinolytic effects.
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