2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress Paper


Vancomycin Powder Embedded in Collagen Sponge Decreases the Rate of Prosthetic Shoulder Infection

Angelo De Crescenzo , MD, Bari ITALY
Alberto Fontanarosa, MD, Santeramo In Colle, Bari ITALY
Nunzio Lassandro, MD, Acquaviva delle Fonti ITALY
Raffaele Garofalo, MD, Acquaviva Delle Fonti-Ba ITALY

Ente Ecclesiastico Ospedale Generale Regionale F. Miulli, Acquaviva delle Fonti, Bari, ITALY

FDA Status Not Applicable

Summary

Intrawound vancomycin powder significantly reduces the rate of periprosthetic shoulder infections without any increase in local and systemic aseptic complications at a minimum follow-up of 12 months.

Abstract

Shoulder prosthesis is a successful procedure to treat the degenerative and traumatic diseases of glenohumeral joint. Periprosthetic infection represents an infrequent but dreaded complication (2-4%). Application of intrawound vancomycin powder seems to reduce periprosthetic infections but limited information is available on its effiency in shoulder arthroplasty. The aim of this study was to evaluate if the vancomycin powder embedded in a collagen sponge could decrease the rate of prosthetic shoulder infection.

A retrospective review of 827 patients undergoing Total Shoulder Arthroplasty (TSA) was performed. The study involved a control group of 405 patients and a group of 422 with the intraoperative insertion of vancomycin powder into the wound. Incidence of periprothesic infection was evaluated into two groups at minimum 12 months follow up. Patient demographics, comorbidities and perioperative information were compared between the two groups.

No infection was observed in the group treated with intra-articular vancomycin, and 13 cases of infection were observed in the control group (3.2%) (P value<.001) without subacromial vancomycin application. No wound complications requiring revision were observed as a result of subacromial vancomycin application.

Intrawound vancomycin powder significantly reduces the rate of periprosthetic shoulder infections without any increase in local and systemic aseptic complications at a minimum follow-up of 12 months. Our results support the use of intrawound local vancomycin for prophylaxis of shoulder periprosthetic infections.