Povidone-iodine may not be superior to saline in reducing infection risk after TKA, THA
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Key takeaways:
- Povidone-iodine did not significantly reduce surgical site infection risk vs. saline irrigation.
- Diabetes, general anesthesia and longer procedure time were linked to increased surgical site infection risk.
SAN FRANCISCO — Povidone-iodine and saline irrigation may have equivalent efficacy for the reduction of surgical site infection following total knee or total hip arthroplasty, according to results presented here.
Andrew R. Grant, BA, and colleagues performed a retrospective, propensity-matched cohort study that analyzed data on 21,482 patients who underwent TKA or THA.
Patients were categorized into two groups: those who received povidone-iodine irrigation and those who received saline irrigation.
Outcomes measured included rates of surgical site infection (SSI), as well as propensity-matched analysis on primary vs. revision arthroplasty, diabetes status, anesthesia status, American Society of Anesthesiologists scores, sex, BMI and age.
In his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting, Grant said there were no significant differences between the rates of SSI in the povidone iodine and saline irrigation groups in univariate analysis.
However, Grant said diabetes, general anesthesia vs. spinal anesthesia and a longer procedure time were linked with an increased SSI risk in multivariate analysis.
Following propensity-matched analysis, Grant said there were 21 cases of SSI in the povidone-iodine group and 19 cases in the saline group, which was not a statistically significant difference.
“Povidone-iodine irrigation may not be superior to saline irrigation in reducing surgical site infection risk,” Grant said. “In situations where financial costs, patient factors or surgeon preference may be a concern, it is reasonable to assume equal efficacy of the products based on our data.”
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Grant AR, et al. Paper 139. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
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