Vancomycin Powder and Dilute Povidone Iodine Lavage for Infection Prophylaxis in High Risk Total Joint Arthroplasty

Inclusion Criteria:

• Patient has no open wounds on operative leg

• Patient is scheduled to undergo elective primary and revision total jointarthroplasty for posttraumatic, osteoarthritis, avascular necrosis, and/orinflammatory arthritis

• Patient does not have active infection on the operative leg, the operative joint

• Patient are identified as high risk for the development of PJI which is determinedby the presence of one or more of the following characteristics: BMI >35, activesmoker, ASA ≥ 3, immunosuppressed (i.e. being treated with chemotherapy, diagnosisof HIV, diagnosis of HCV, being treated with chronic steroids, patients withinflammatory arthropathies), diagnosis with diabetes mellitus, establishedcolonization with S. aureus, or any patient undergoing revision TJA

• Patient understand the risks and benefits associated with TJA and willing tocooperate and follow study protocol and visit schedule

Exclusion Criteria:

• Patient is pregnant

• Patient is unable to provide written consent

• Patient has psychiatric disorder that precludes safe study participation or thatnecessitates confinement in a custodial environment at home or in a chronic carefacility

• Patient does not have the mental capacity to participate and comply with the studyprotocol

• Patient has active infections in the operative leg/joint

• Patient has severe dementia

• Suspicion of illicit drug abuse by patient

• ASA score of 5 & 6

• History of prior native septic joint arthritis

• No planned procedure within 90 days of surgery