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Minimally Invasive Total Knee Arthroplasty Medication

  • Author: Derek F Amanatullah, MD, PhD; Chief Editor: Erik D Schraga, MD  more...
Updated: Apr 30, 2015

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.



Class Summary

The American Academy of Orthopaedic Surgeons has recommended the use of prophylactic antibiotics that include cefazolin, cefuroxime, or vancomycin. The antibiotics should be administered 60 minutes prior to the procedure and discontinued within 24 hours of the procedure. However, for outpatient/office-based procedures, a single preprocedure dose is sufficient.



Cefazolin is a first-generation semisynthetic cephalosporin that arrests bacterial cell wall synthesis, inhibiting bacterial growth.

Cefuroxime (Ceftin, Zinacef)


Cefuroxime is a second-generation cephalosporin that maintains the gram-positive activity of first-generation cephalosporins; it adds activity against Proteus mirabilis, Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, and Moraxella catarrhalis. The condition of the patient, the severity of the infection, and the susceptibility of the microorganism determine the proper dose and route of administration.



Vancomycin is a potent antibiotic that is directed against gram-positive organisms and that is active against Enterococcus species. It is useful in the treatment of septicemia and skin structure infections. Vancomycin is indicated for patients who cannot receive or have not responded to penicillins and cephalosporins and for patients who have infections with resistant staphylococci.

Contributor Information and Disclosures

Derek F Amanatullah, MD, PhD Assistant Professor, Department of Orthopaedic Surgery, Stanford University School of Medicine

Derek F Amanatullah, MD, PhD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, Orthopaedic Research Society, American Association of Hip and Knee Surgeons, California Orthopedic Association, International Cartilage Repair Society

Disclosure: Received honoraria from Sanofi for message board participation; Received honoraria from Medscape for manuscript preparation; Received intellectual property rights from Dynamic Tension Plantar Fasciitis Splint for patent pending; Received intellectual property rights from Cool Cut Cast Saw Blade for patent pending.


Paul E Di Cesare, MD 

Paul E Di Cesare, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

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Midline skin incision is performed. Mini-incision is approximately twice length of patella, 6-14 cm (blue); conventional incision is longer (red extensions).
Parapatellar arthrotomy is performed (ie, median parapatellar, midvastus, subvastus, or lateral) to access knee joint and perform arthroplasty.
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