Vancomycin given into the joint, into bone, or by IV during total knee replacement
Official 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
Run by University of California, San Diego · NCT07282782 · Data updated 2026-11-12
This trial will test whether a single dose of vancomycin injected into the knee joint before a primary total knee replacement protects against infection as well as vancomycin given into bone or by IV for adults treated at UC San Diego.
Quick facts
| Phase | Phase 4 |
|---|---|
| Study type | Interventional |
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 30 (estimated) |
| Sponsor | University of California, San Diego Academic / other |
| Drugs / interventions | chemotherapy, radiation |
| Locations | 1 site (San Diego, California) |
| Status | Recruiting |
| Started | June 10, 2024 |
| Main results expected | December 31, 2026 |
| Study ends | December 31, 2028 |
| Registry record updated | June 3, 2026 |
| Trial ID | NCT07282782 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults (≥18 years) receiving care at UC San Diego Health who are scheduled for primary unilateral total knee arthroplasty, can provide consent, and meet medical eligibility criteria are appropriate candidates.
✕Probably not a fit
Those who are excluded—such as people with prior knee surgery (other than arthroscopy), BMI >35, uncontrolled diabetes, immunosuppression, chronic kidney disease, or vancomycin allergy—would not be eligible and therefore would not benefit from participation in this protocol.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This randomized, parallel-group, phase 4 study at UC San Diego compares three methods of preoperative vancomycin prophylaxis—intraarticular injection, intraosseous injection, and intravenous infusion—in adults undergoing primary unilateral total knee arthroplasty. Participants are randomized to one of the three arms and receive vancomycin before surgery; intraosseous administration requires an additional puncture and specialized device. The trial excludes patients with prior knee surgery (except arthroscopy), BMI >35, vancomycin/cefepime/cefazolin contraindications, uncontrolled diabetes, immunosuppression, chronic kidney disease, or active infections. Investigators hypothesize that intraarticular injection will be non-inferior to intraosseous injection while reducing wounds, procedure time, and cost.
Why it matters
Potential benefit: If successful, patients could receive similar protection from infection with a simpler intraarticular injection instead of an extra bone injection, potentially reducing wounds, time, and cost.
How similar studies have gone: Intravenous and intraosseous vancomycin have established use for perioperative prophylaxis, but randomized head-to-head comparisons that include intraarticular injection are limited, so this direct comparison is relatively novel.
Who can join: the full rules
Show full inclusion / exclusion criteria
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
Where it's running
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University of California, San Diego
San Diego, California, United States Recruiting
Study contacts
- Study coordinator: Dominic Baun
- Email: jbaun@health.ucsd.edu
- Phone: 858-534-8268
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.