Joint Replacement Study Demonstrates Feasibility and Safety of Prophylactic Irrigation Solutions and Topical Antibiotics

Strategic Insights -

A new study conducted by researchers at McMaster University in Canada has demonstrated the feasibility and safety of using prophylactic irrigation solutions and topical antibiotics to prevent periprosthetic joint infection (PJI) in total joint replacement surgeries. The study, titled "The Prospective Randomized EValuation of Emerging Novel Treatments for Infection Prophylaxis in Total Joint Replacement (PREVENT-iT)," was funded by the Canadian Institutes of Health Research and involved 495 participants.

Key Takeaways:

  • The study used a simple randomized 3 x 2 factorial trial to assess the feasibility of conducting a definitive trial to determine the optimal prophylactic treatment of PJIs using various irrigation solutions and topical antibiotics.
  • The study found that 7 out of 9 criteria assessing feasibility indicated that the trial was successful and no modifications were needed.
  • Two criteria, treatment contamination (8.5%) and completeness of patient follow-up (93.8%), were graded as requiring minor adjustment before conducting the definitive trial.
  • The study found that there were 114 serious adverse events, none of which were deemed associated with the treatments.
  • 9 (1.84%) of study participants presented with PJIs requiring reoperation, and 6 patients (1.12%) presented with persistent wound drainage (PWD).
  • The study concluded that prophylactic irrigation solutions and topical antibiotics are safe and feasible for preventing PJI in total joint replacement surgeries.
  • The PREVENT-IT study has received funding from the Canadian Institutes of Health Research toward the definitive, large, multicenter randomized controlled trial (NCT06126614).

Statistics:

  • 495 participants were included in the pilot trial.
  • 56% of study participants were female, and the mean age was 67 years.
  • 8.5% of study participants contaminated their treatment.
  • 93.8% of study participants completed the trial with complete patient follow-up.
  • 114 serious adverse events occurred, none of which were associated with the treatments.
  • 9 (1.84%) of study participants presented with PJIs requiring reoperation.
  • 6 patients (1.12%) presented with PWD.

Sources:

  • NewsRx. Research on Joint Replacement Discussed by Researchers at McMaster University [The Prospective Randomized EValuation of Emerging Novel Treatments for Infection Prophylaxis in Total Joint Replacement (PREVENT-iT)]. Medical Devices & Surgical Technology Week. October 26, 2025; p 1641.
  • JBJS Open Access, 2025,10(3). (JBJS Open Access - http://journals.lww.com/jbjsoa)
  • Wolters Kluwer, publisher of JBJS Open Access.