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Intraosseous (IO) Cefazolin and Vancomycin in Primary Total Knee Arthroplasty (TKA)

Intraosseous Vancomycin and Cefazolin vs Intravenous Administration in Primary Total Knee Arthroplasty

Who can join

Ages 18 and older · All sexes

Inclusion Criteria:

* Patient is scheduled to undergo an elective primary total knee arthroplasty.
* Patient is able to understand the study design and intervention and gives informed consent to participate in the study.
* Patient is 18 years or older.

Exclusion Criteria:

* Contraindication to receiving vancomycin or cefazolin.
* Body mass index (BMI) \> 40.
* Uncontrolled Diabetes (defined as A1c \> 7.5%).
* Patient received or is scheduled to receive IV vancomycin or cefazolin within 7 days prior to their planned procedure.
* Any hardware, condition, or anatomic status that prevents the tibial tubercle from being a viable intraosseous injection site.
* Refusal to participate
* Any condition, in the opinion of the primary investigator, that deems the participant unsuitable for participation in the research study.

About the study

The goal of this clinical trial is to compare the efficacy of intravenous (IV) and intraosseous (IO) antibiotic administration techniques during primary total knee arthroplasty (TKA) in adults undergoing a TKA procedure at Houston Methodist Hospital. The main questions it aims to answer are:

Does IO administration of vancomycin and cefazolin protect against perioperative exposure risks? Is there a difference in post-operative complication rates between IV and IO administration of these drugs?

Participants will be randomized to receive either the standard of care IV administration of Vancomycin and Cefazolin, or the IO administration of Vancomycin and Cefazolin.

What is being tested

• IO Administration of Cefazolin (drug)
• IO Administration of Vancomycin (drug)
• IV Administration of Cefazolin (drug)
• IV Administration of Vancomycin (drug)

Sponsor: The Methodist Hospital Research Institute · Participants: 40 · Started: May 15, 2025

Contact the study team

• Thomas Sullivan · Phone: 346-238-1603

Official record on ClinicalTrials.gov — NCT06640491

Locations in the U.S.

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.