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Title: Contemporary strategies to prevent infection in hip and knee arthroplasty.
Epworth Authors: Batty, Lachlan
Other Authors: Lanting, Brent
Keywords: Hip Arthroplasty
Knee Arthroplasty
Prosthetic Joint Infection
Lower Limb Arthroplasty
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Aug-2020
Publisher: Springer
Citation: Curr Rev Musculoskelet Med. 2020 Aug;13(4):400-408
Abstract: Purpose of review: Prosthetic joint infection (PJI) remains a serious concern in lower limb arthroplasty. Despite the significant consequences of PJI, the assessment of the safety and efficacy of preventative measures is challenging due to a low event rate. Notwithstanding, enormous efforts have been made in this arena, and prevention strategies continue to evolve. This review provides an update on contemporary literature (published within the last 5 years) pertaining to infection prevention in primary hip and knee arthroplasty. Recent findings: Patient optimization has been highlighted as a critical preoperative factor in mitigating PJI risk. Recent evidence emphasizes the importance of preoperative glycaemic control, nutritional status, weight optimization and smoking cessation prior to hip and knee arthroplasty. Perioperatively, attention to detail in terms of surgical skin preparation agent and technique as well as prophylactic antibiotic agent, spectrum, dose and timing is important with statistically and clinically significant differences seen between differing strategies. Intraosseous regional antibiotic administration is an emerging technique with promising preclinical data. Dilute betadine lavage also shows promise. Data supporting bundled interventions continues to grow. A multimodal approach is required in PJI prevention, and attention to detail is important with each element. Patient optimization is critical, as is the execution of the planned perioperative infection prevention strategy.
DOI: 10.1007/s12178-020-09653-9
PubMed URL:
ISSN: 1935-9748
Journal Title: Current Reviews in Musculoskeletal Medicine
Type: Journal Article
Affiliated Organisations: Division of Orthopaedic Surgery, University Hospital, London Health Sciences Centre, Western University, London, Ontario, Canada.
Type of Clinical Study or Trial: Review
Appears in Collections:Musculoskeletal

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