How effective is diluted povidone-iodine in preventing periprosthetic joint infection in total joint arthroplasty (TJA)? An updated systematic review and meta-analysis

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#humans #povidone-iodine #arthroplasty-replacement-hip #prosthesis-related-infections #arthritis-infectious

How effective is diluted povidone-iodine in preventing periprosthetic joint infection in total joint arthroplasty (TJA)? An updated systematic review and meta-analysis

Ebrahimzadeh et al., 2023 | BMC Musculoskelet Disord | Meta Analysis

Citation

Ebrahimzadeh Mohammad-H, Safdari Mohammad-R, ... Daliri Mahla. How effective is diluted povidone-iodine in preventing periprosthetic joint infection in total joint arthroplasty (TJA)? An updated systematic review and meta-analysis. BMC Musculoskelet Disord. 2023-May-25;24(1):416. doi:10.1186/s12891-023-06548-x

Abstract

PURPOSE: Periprosthetic joint infection (PJI) is a serious complication with total joint arthroplasty (TJA), that necessitates reoperation. Pre-closure irrigation with dilute povidone-iodine (PI) is among the preventive measures, but its efficiency is still controversial. As a result, the focus of this systematic review and meta-analysis is on the effect of dilute PI wound irrigation in the prevention of PJI following TJA. METHODS: We systematically reviewed and analyzed articles that compared PI with other agents in terms of PJI rate after TJA, searching Medline, Scopus, Web of science, and Cochrane databases. A number of 13 papers including 63,950 patients in total, were finally considered in qualitative and quantitative assessments. We have also further assessed review articles. RESULTS: In comparison with normal saline (NS), PI reduced post-operative infection rate (OR: 0.44; CI 95%: 0.34-0.56). However, there was no difference between PI and chlorhexidine (CHG) (OR: 1.61; CI 95%: 0.83-3.09)) or undetermined comparators (OR: 1.08; CI 95%: 0.67-1.76). CONCLUSION: PI irrigation seems an efficient preventive measure for post-operative PJI and would seem to be the most feasible for TJA protocol.

Key Findings

In comparison with normal saline (NS), PI reduced post-operative infection rate (OR: 0.44; CI 95%: 0.34-0.56). However, there was no difference between PI and chlorhexidine (CHG) (OR: 1.61; CI 95%: 0.83-3.09)) or undetermined comparators (OR: 1.08; CI 95%: 0.67-1.76).

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 63950
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Povidone-Iodine
  • Arthroplasty, Replacement, Hip
  • Prosthesis-Related Infections
  • Arthritis, Infectious
  • Surgical Wound Infection
  • Retrospective Studies

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Meta-Analysis, Systematic Review, Journal Article
  • Vertical: iodine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09