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Abstract title: Post-operative antibiotic prophylaxis in total hip and knee
arthroplasty: A systematic review and meta-analysis of randomized controlled
trials
Purpose of Study:
Post-operative antibiotic prophylaxis is currently the standard of care for patients
undergoing total hip and knee arthroplasty. We evaluated the evidence for this
practice in the reduction of surgical site infections.
Description of methods:
We systematically searched MEDLINE, Embase, and the Cochrane Library for
randomized controlled trials published up to October 1, 2015 using MeSH and
EMTREE headings with free text combinations. We included all randomized controlled
trials that compared post-operative antibiotic prophylaxis to post-operative placebo
or no treatment. Surgical site infection outcomes were combined using a random
effects model and heterogeneity was quantified using the chi-squared test and the
I 2 statistic. We assessed the overall quality of the evidence according to the Grading
of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
Summary of results:
Across four eligible randomized controlled trials (n=4036), there were 63/2055
(3.1%) surgical site infections in the prophylaxis group and 45/1981 (2.3%) surgical
site infections in the placebo/no treatment group. Post-operative prophylaxis did not
reduce the rate of surgical site infections compared to placebo (risk difference 0.01,
95% Confidence Intervals [CIs’] -0.00 to 0.02, p = 0.19; I 2 =26%). This result was
robust to sensitivity testing for losses to follow-up. According to the GRADE approach,
the overall quality of evidence was ‘very low’.
Conclusions:
The available evidence does not demonstrate efficacy for post-operative antibiotic
prophylaxis for prevention of surgical site infections in patients undergoing total hip
and knee arthroplasty. Multi-center randomized controlled trials are likely to have an
important impact on the confidence in the effect estimate and to change the estimate
itself.
Paper 79
Presenter: M Haber
Authors: M.D. Haber, D.J. Bokor, S. Ahmad, D Biggs, B. Gooding, E. Dolev
Demshchak
Disclosure: No
Abstract title: Clinical Outcome Scores Following Arthroscopic Rotator Cuff Who
Re-Tear: Patients Prior To Re-Tearing Are Better Than Patients That Don’T Re-Tear
1. Purpose of study.
Establishing factors relating to patient who re-tear outcomes is of significant clinical
importance. Numerous papers have established pre-operative and intra-operative
factors that predispose to re-tearing. There has been little written about post-operative
factors which predispose to re-tearing. Understanding characteristics within post-
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