Should antibiotics be administered before arthroscopic knee surgery?A systematic review of the literature

• 作者: Alexander E Weber Carleton Thomas Vangsness Jr. Erik N Mayer George F Hatch III John Carney Nathanael Heckmann Ram K Alluri
• 来源期刊: 世界骨科杂志
• 学科: 医学
• 关键词: Knee ARTHROSCOPY ANTIBIOTICS Systematic review VANCOMYCIN ANTERIOR CRUCIATE LIGAMENT
• 年，卷（期）: 2018,（11）
• 页码范围: 262-270
• 页数: 9页
• 分类号: R

摘要

AIM To explore the current evidence surrounding the administration of prophylactic antibiotics for arthroscopic knee surgery.METHODS Databases were searched from inception through May of 2018 for studies examining prophylactic antibiotic use and efficacy in knee arthroscopy.Studies with patient data were further assessed for types of arthroscopic procedures performed,number of patients in the study,use of antibiotics,and outcomes with the intention of performing a pooled analysis.Data pertaining to“deep tissue infection”or“septic arthritis”were included in our analysis.Reported data on superficial infection were not included in our data analysis.For the pooled analysis,a relative risk ratio was calculated andχ2 tests were used to assess for statistical significance between rates of infection amongst the various patient groups.Post hoc power analyses were performed to compute the statistical power obtained from our sample sizes.Number needed to treat analyses were performed for statistically significant differences by dividing 1 by the difference between the infection rates of the antibiotic and no antibiotic groups.An alpha value of 0.05 was used for our analysis.Study heterogeneity was assessed by Cochrane’s Q test as well as calculation of the I^2 value.RESULTS A total of 49682 patients who underwent knee arthroscopy for a diverse set of procedures across 19 studies met inclusion critera for pooled analysis.For those not undergoing graft procedures,there were 27 cases of post-operative septic arthritis in 34487 patients(0.08%)who received prophylactic antibiotics and 16 cases in 10911(0.15%)who received none[risk ratio(RR)=0.53,95%confidence interval(CI):0.29-0.99,P=0.05].A sub-group analysis in which bony procedures were excluded was performed which found no significant difference in infection rates between patients that received prophylactic antibiotics and patients that did not(P>0.05).All anterior cruciate ligament reconstruction studies used prophylactic antibiotics,but two studies investigating