Kildow BJ, Patel SP, Otero JE, et al. - For the treatment of acute periprosthetic joint infection (PJI), debridement, antibiotics, and implant retention (DAIR) remains an option despite imperfect success rates. Significantly increased local bone and tissue concentrations of antibiotics are observed in correlation with intraosseous (IO) administration of vancomycin compared with systemic antibiotics alone. Researchers herein examined if outcomes can be improved by adding a single dose of IO regional antibiotics to the protocol at the time of DAIR. A retrospective case series comprising 35 PJI TKA patients, with a median age of 67 years (interquartile range (IQR) 61 to 75), received treatment involving DAIR combined with IO vancomycin (500 mg); minimum 12 months' follow-up was performed in this case series. Outcomes support the safety of adding IO vancomycin at the time of DAIR along with achievement of improved results compared with current literature using standard DAIR without IO antibiotic administration. In chronic infections, caution should be practiced in using this technique. While these results are encouraging, longer follow-up is required prior to widespread adoption of this technique.