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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 2, issue 1
J. Bone Joint Infect., 2, 10–14, 2017
https://doi.org/10.7150/jbji.16448
© Author(s) 2017. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 2, 10–14, 2017
https://doi.org/10.7150/jbji.16448
© Author(s) 2017. This work is distributed under
the Creative Commons Attribution 4.0 License.

Review 01 Jan 2017

Review | 01 Jan 2017

Treatment of Periprosthetic Joint Infection Using Antimicrobials: Dilute Povidone-Iodine Lavage

John A. Ruder1 and Bryan D. Springer2 John A. Ruder and Bryan D. Springer
  • 1Carolinas Medical Center, Department of Orthopaedics;
  • 2OrthoCarolina Hip and Knee Center, Charlotte, NC 28207.

Keywords: Periprosthetic joint infections, antimicrobials

Abstract. Periprosthetic joint infections (PJI) remain a challenge for the orthopaedic surgeon to treat and remain a leading cause of failure of both primary and revision total joint arthroplasty. Once a PJI develops, surgical treatment is generally indicated and includes an aggressive irrigation and debridement. One component of the irrigation and debridement involves the use of an antiseptic irrigating solution. In primary and revision TJA, dilute povidone-iodine lavage can be performed prior to wound closure. Approximately 17.5mL of 10% povidone-iodine is diluted with 500-1000cc of normal saline. The wound is then irrigated with the dilute povidone-iodine for 3 minutes. The dilute povidone-iodine is then thoroughly irrigated and washed out of the wound with normal saline prior to wound closure. The use of dilute povidone-iodine lavage prior to wound closure has been shown to reduce the risk of deep surgical site infection in multiple surgical specialties. In primary TJA, it has been demonstrated to reduce the risk of infection, without any associated adverse effects. It is also included in multiple protocols for the surgical treatment of PJI. Dilute povidone-iodine lavage provides a safe and inexpensive method to reduce the rate of PJI in TJA.

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