Medicinal, Psychological, and Health Research Journal (MPHRJ)

Effectiveness of Antibiotic Prophylaxis in Preventing Postoperative Infection Following Total Knee Arthroplasty: A Systematic Review

Document Type : Systematic Review

Authors

Alireza Aghili 1
Sina Najafi 2

1 Assistant Professor of Orthopaedics, Department of Orthopedics, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

2 Department of Infectious Disease, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

10.22034/mphrj.2026.587088.1104
Abstract
Introduction: Total knee arthroplasty is an effective treatment for advanced knee disorders but remains vulnerable to postoperative infections, including periprosthetic joint infection, which can lead to serious complications and increased healthcare burden. Antibiotic prophylaxis is widely used to reduce this risk, yet optimal strategies remain debated. Therefore, this study aims to systematically review the evidence regarding the effectiveness of antibiotic prophylaxis in preventing infection following TKA.

Material and methods: This systematic review was conducted according to PRISMA guidelines. Eligible studies included randomized and observational research evaluating antibiotic prophylaxis in adult patients undergoing total knee arthroplasty with reported postoperative infection outcomes. Multiple databases were searched using MeSH terms and related keywords by two independent reviewers. Study quality was assessed using the Newcastle–Ottawa Scale and the Cochrane Risk of Bias tool.

Results: The literature search identified 851 records, of which nine studies met the inclusion criteria after screening and full text assessment. Overall, intravenous antibiotic regimens demonstrated moderate to high treatment success across studies, with reported success rates ranging from 63% to 90% and follow up durations varying between 3.5 and 72 months. Most regimens involved glycopeptide or rifampicin based therapies administered for approximately 2–6 weeks, with generally favorable clinical outcomes.

Conclusion: The available evidence suggests that intravenous antibiotic therapy provides generally favorable outcomes in the management of infection related complications. Across the included studies, treatment success was consistently moderate to high despite variations in antimicrobial regimens, treatment duration, and follow up periods. Glycopeptide and rifampicin based therapies appear to play a central role in achieving effective infection control.

Graphical Abstract

Effectiveness of Antibiotic Prophylaxis in Preventing Postoperative Infection Following Total Knee Arthroplasty: A Systematic Review

Keywords

intravenous antibiotics
infection management
antimicrobial therapy
treatment outcomes
Subjects
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Medicinal, Psychological, and Health Research Journal (MPHRJ)
Volume 2, Issue 6
November and December 2026
Pages 429-437

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