Jack Hughston Memorial Hospital, Phenix City, AL, USA.
Hughston Foundation, Columbus, GA, USA.
Orthop Surg. 2024 Jun;16(6):1277-1283. doi: 10.1111/os.14052. Epub 2024 Apr 16.
Primary joint arthroplasty (JA) is one of the most common operating room (OR) procedures, with knee and hip arthroplasties being listed in the top five most frequent OR procedures and while not as common, shoulder arthroplasties are increasing at greater rates than knee and hip arthroplasties. Periprosthetic joint/shoulder infections (PJI/PSI) are a devastating complication of primary JAs with infection prevention deemed as the single most important strategy in combating them. The objective of this study was to retrospectively evaluate the efficacy of XPERIENCE® Advanced Surgical Irrigation (XP) in preventing PJI following primary joint arthroplasty.
This is a retrospective study of primary knee, hip and shoulder arthroplasties that were performed by multiple orthopedic surgeons at a single hospital setting. XPERIENCE was used as an intraoperative surgical irrigant either solely, or with other intraoperative practices for prevention of infection. Incidence of acute PJI occurring within 90 days of index surgery were retrospectively collated.
Four hundred and twenty-three (423) primary joint replacement surgeries treated intraoperatively with XP, were evaluated for acute PJI incidence. Retrospective evaluations determined that 95% of the subjects had at least one risk factor predisposing them to PJI. There were zero PJIs diagnosed in the knee and hip arthroplasty cohorts and zero PSIs diagnosed in the shoulder arthroplasty cohorts.
The absence of PJI/PSI diagnoses in the JA cohorts treated intraoperatively with XP indicates that it could be an efficacious antimicrobial irrigant in preventing PJI, and warrants being evaluated in prospective, randomized controlled clinical trials as the sole intraoperative irrigant, as well as in combination with the other intraoperative infection prevention regimens evaluated in this retrospective study.
初次关节置换术（JA）是最常见的手术室（OR）手术之一，膝关节和髋关节置换术位列 OR 中最常见的前 5 大手术，而肩关节置换术虽然不那么常见，但发病率的增长速度却高于膝关节和髋关节置换术。假体周围关节/肩部感染（PJI/PSI）是初次 JA 的一种毁灭性并发症，预防感染被认为是对抗感染的最重要策略。本研究的目的是回顾性评估 XPERIENCE®高级外科冲洗（XP）在预防初次关节置换术后 PJI 中的疗效。
这是一项回顾性研究，纳入了在一家医院由多位骨科医生进行的初次膝关节、髋关节和肩关节置换术。XP 被用作术中手术冲洗液，单独或与其他术中预防感染措施联合使用。回顾性收集索引手术后 90 天内发生的急性 PJI 的发生率。
对 423 例接受 XP 术中治疗的初次关节置换手术进行了急性 PJI 发生率评估。回顾性评估确定，95%的受试者至少有一个易患 PJI 的风险因素。膝关节和髋关节置换术队列中未诊断出 PJI，肩关节置换术队列中未诊断出 PSI。
在接受 XP 术中治疗的 JA 队列中未诊断出 PJI/PSI，表明它可能是一种有效的抗菌冲洗液，可预防 PJI，因此值得在前瞻性、随机对照临床试验中进行评估，作为唯一的术中冲洗液，并与本回顾性研究中评估的其他术中感染预防方案联合使用。
