Novel Irrigation Reduces Prosthetic Joint Infection Rates: Meta-analysis of 3 clinical studies

Abstract

Prosthetic joint infection (PJI) in the setting of total joint arthroplasty represents significant morbidity and economic burden to patients and the healthcare system. We analyzed a non-toxic, no-rinse intraoperative antimicrobial irrigation solution (AIS) that was designed to combat infection. In this meta-analysis of three studies, the AIS rate of PJI was 0.727 per 1000 surgeries (95% CI: [0.041, 3.19]), which was significantly less than the standard of care (SOC) rate of infection of 4.854 per 1000 (95% CI: [1.178, 27.73]) (p=0.045). This corresponds to a reduction of 85% in the odds of PJI (p = 0.045, 95% CI: [24%, 99%]). When compared to the American Association of Hip and Knee Surgeons (AAHKS) estimate of 1 infection per 100 surgeries, the AIS rate of infection was significantly less (p=0.004). The use of this AIS intraoperatively represents an efficient and effective technique to combat PJI in the setting of total joint arthroplasty.