Table 1 Included studies’ characteristics
N | Author (year) | Study design | Surgery | Sample size (case + control) | Age | Sex (% female) | Follow up (months) | PI concentration | Intervention method | Control group | PJI diagnostic guideline | MINORS Score |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Nazal et al. (2019) | RCT | Primary TJA | 53 + 51 | Post- operation (48 h) | 0.02% | 2 L of SW was placed into the splash basin, then 4 oz of 10% povidone-iodine solution was added | SW | Microbial growth after 48 h | 22 | ||
2 | Slullitel et al. (2019) | RSC | Primary TJA | 2268 + 2268 | 64.5 ± 12.0 | 54.9 | 3 | 0.2–0.35% | 22.5 mL for 1–3 min | NS | MIS and ICG | 18 |
3 | Hart et al. (2019) | RSC | Revision TJA | Hip: 231 + 946 | 66.5 ± 12.5 | 51.1 | 3 and 12 | 0.25% | 1 L, 3 min followed by irrigation with normal saline solution prior to closure | NR | Infections deep to the fascia, as reported in the medical record | 18 |
Knee: 319 + 889 | 65.5 ± 11.1 | 52.1 | ||||||||||
4 | Hernandez et al. (2019) | RSC | Primary TJA | Hip: 912 + 3725 | 63.5 ± 13.7 | 51.2 | 3 and 12 | 0.25% | 1 L, for 3 min | NR | Infections deep to the fascia, as reported in the medical record | 18 |
Knee: 1745 + 3489 | 67.4 ± 10.0 | 56.1 | ||||||||||
5 | Calkins et al. (2019) | RCT | Revision TJA | 223 + 234 | 64.5 ± 9.0 | 50 | 3 | 0.35% | 500 ml, 3 min, followed by 1 L 0.9% NaCl pulsatile lavage with skin PI painting | NS | MIS | 24 |
6 | Shohat et al. (2021) | RSC | Primary TJA | 8659 + 22,672 | 64.7 ± 10.7 | 51.95 | 12 | 0.30% | PI solution was poured into the wound for approximately 3 min, after which pulsed irrigation using 1 L of sterile saline was performed | NS | International Consensus Meeting criteria 2018 | 18 |
7 | Brown et al. (2012) | RSC | Primary TJA | 688 + 1862 | 63.55 | 66.55 | 3 | 0.35% | 500 ml, 3 min, followed by 1 L 0.9% NaCl pulsatile lavage with PI painting | NS | Following the criteria described by Lonner et al. | 20 |
8 | Driesman et al. (2020) | RSC | Primary TJA | 1227 + 1159 | 65.14 ± 10.19 | 63.78 | 3 and 12 | 17.5mL of 10% povidone-iodine mixed with 500 cc of sterile saline | 3 min | CHG | MIS | 17 |
9 | Frisch et al. (2017) | RSC | Primary TJA | 253 + 386 | 65.9 | 60 | 12 | < 2% | Irrigation with 0.9% saline followed by a 2-minute soak with PI which was washed out entirely before closure | CHG | MIS | 15 |
10 | Matsenko et al. (2016) | RSC | Primary TJA | 1053 + 1167 | 12 | 0.35% | Soaking for 3 min with 500 mL PI solution after implantation, followed by 1 L 0.9% NaCl pulsatile lavage with skin PI painting | NR | MIS | 17 | ||
11 | Muwanis et al. (2022) | RSC | Primary TJA | 1207 + 1511 | 70.8 ± 9.35 | 61 | > 3 | Betadine irrigation (6.5 mL of commercial povidone-iodine (10% solution, 100 g/L) mixed with standard 500-mL bottle of sterile saline solution | 3 min | NS | International Consensus by Parvizi et al. 2014 | 20 |
12 | Fleischman et al. (2018) | RSC | Primary TKA | 2124 + 7665 | 3 | Dilute PI | Irrigation | NR | CDC | NR | ||
13 | Lung et al. (2022) | Retrospective cohort | Primary TJA | 206 + 204 | 66.3 ± 11.1 | 50 | 3 | 17.5 mL of 10% povidone-iodine solution with 500 mL of sterile normal saline | 3 min | CHG | MIS | 17 |