Use of Antibiotic Lavage in Total Knee Replacement to Prevent Postoperative Infection

Almaawi, Abdulaziz; Aldalbahi, Ghazi; Albqami, Sara N; Barri, Abdulrahman; Albatly, Mada; Arafah, Orfan

doi:10.7759/cureus.32727

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Some experimental studies on in vivo models have reported that antibiotics decrease the quantity of the microorganisms from the wound surface when compared with other irrigants 14,15 . Almaawi et al 16 demonstrated that the use of intraoperative vancomycin lavage during total knee arthroplasty (TKA) was associated with a decrease in the incidence of postoperative surgical site infection when compared with no antibiotic lavage; however, this did not reach statistical significance. Conversely, other investigators have demonstrated that additives including antibiotics have a negative effect on wound healing and increase reinfection rates when compared with other solutions such as normal saline 9,14,15,17 .…”

Section: Traditional Irrigantsmentioning

confidence: 99%

A Review of Surgical Irrigation Solutions for Infection Prevention in Orthopaedic Surgery

Chambers,

Namdari

2023

JBJS Reviews

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» Intraoperative surgical irrigation is a common practice in orthopaedic procedures, although there is no universally established standard of care due to a lack of concrete data supporting an optimal irrigation agent.» Isotonic normal saline has long been considered a safe and cost effective solution for wound irrigation as compared with other antibiotic and antiseptic irrigation solutions.» Currently, the only adjunct to saline that is formally supported by American Academy of Orthopaedic Surgeons, the Centers for Disease Control and Prevention, and World Health Organization is povidone-iodine.» Further in vivo clinical studies are needed to identify the ideal irrigation solution that carries low cytotoxic effects while also exerting optimal antimicrobial properties.

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Section: Traditional Irrigantsmentioning

confidence: 99%

A Review of Surgical Irrigation Solutions for Infection Prevention in Orthopaedic Surgery

Chambers,

Namdari

2023

JBJS Reviews

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“…In total hip and total knee arthroplasty, a vast body of literature has outlined prosthetic joint infection (PJI) predictors, diagnostic criteria, and mitigation strategies. 1,3,6,20,23,24,27,28,34,35,39 In contrast, relatively little has been published regarding infection in TAA. 2…”

Section: Introductionmentioning

confidence: 99%

A Propensity Score Matched Exploration of Infection in Primary Total Ankle Arthroplasty

Anastasio,

Wu,

Kim

et al. 2023

Foot Ankle Int.

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Background: Infection is a serious complication of primary total ankle arthroplasty (TAA) and can lead to implant failure and revision surgery. Various demographic, comorbidity, and surgical factors have been associated with an increased risk of infection. However, the evidence base remains limited, and further research is needed regarding infection in TAA. This study aims to analyze risk factors of infection and explore outcomes following infected TAA. Methods: A retrospective cohort study was conducted using data from a single institution from 2002 to 2022. Patients who underwent primary TAA and had subsequent infection were identified through annual registry surveillance and matched using propensity score matching (PSM) based on various demographic, comorbidity, and surgical factors. Demographics were compared between the matched groups using Mann-Whitney U test and Fisher exact test. The outcomes following infection were identified and summarized using descriptive statistics. Results: A total of 1863 patients who underwent primary TAA were identified, and 19 were diagnosed with an infection. The identifiable overall infection rate was 1.0%. After PSM, there were no significant differences in the difference in age, gender, BMI, and smoking status between the infected and control cohort. There was a statistically significant increase in the rate of diabetes in the infected cohort. The subsequent surgical intervention resulted in limb salvage in 18 (94.7%) cases. Out of the total number of cases, 2-stage revision to total ankle replacement was performed in 7 cases, whereas revision to arthrodesis and isolated polyethylene exchange were each carried out in 4 cases. One patient had to undergo amputation; however, at the time of the most recent follow-up, all patients were found to be free of infection. Conclusion This study demonstrated high rates of a history of smoking and diabetes in the infected TAA cohort. The diabetes rate in the infected group was significantly higher than the noninfected controls. Two-stage revision to total ankle replacement was performed in 7 cases, and revision to arthrodesis and isolated polyethylene exchange were each carried out in 4 cases. Overall, a high rate of limb salvage was reported. Level of Evidence: Level III, case-control study.

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Use of Antibiotic Lavage in Total Knee Replacement to Prevent Postoperative Infection

Cited by 2 publications

References 29 publications

A Review of Surgical Irrigation Solutions for Infection Prevention in Orthopaedic Surgery

A Review of Surgical Irrigation Solutions for Infection Prevention in Orthopaedic Surgery

A Propensity Score Matched Exploration of Infection in Primary Total Ankle Arthroplasty

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