🔍 Key Findings
- No infections (0/102) occurred in cases where preclosure povidone-iodine lavage (PrePIL) was used, compared to 21/2111 (0.99%) with saline lavage.
- Break-even cost for PrePIL was calculated at $49.74, while the actual cost was only $2.07, confirming strong cost-effectiveness.
- No adverse reactions or healing complications were reported in the 102 PrePIL cases.
- The PrePIL protocol used 0.35% povidone-iodine for 3 minutes before closure, followed by sterile saline lavage.
- Majority of THRs (97%) used cementless fixation (BFX) in PrePIL group; only 3 cases used CFX components.
- Surgeries followed consistent perioperative antibiotic protocols, making PrePIL the only major protocol variable.
- Antibiotics were not added to lavage, aligning with WHO and CDC guidelines for antimicrobial stewardship.
- The infection reduction with PrePIL supports routine use in total hip replacement to reduce periprosthetic joint infections.
