Grant: Project Grant

Osteoarthritis, a joint disease in which the tissues in the joint break down over time, is the most common cause of disability in older adults worldwide. A total joint replacement removes the damaged joint and replaces it with a device designed to replace the joint, in order to improve patient functionality, pain, and quality of life. Despite its success, there is a small but serious risk of infection following a total joint replacement. About, 2% of patients develop an infection. Infections often require continued treatment including reoperations and sometimes amputation. Finding ways to reduce joint infection would have major benefits to patients. A standard practice to help reduce infections is to wash the surgical wound with a surgical site wash prior to closing the surgical cut. Surgeons use a number of surgical site washes to wash the wound but it is unclear whether one is better at reducing infections. The purpose of this study is to determine which surgical site wash is most effective in reducing the number of infections that require a reoperation and whether the use of local antibiotics reduces the number of infections that require a reoperation. To do this, study participants will be randomly divided by chance to recieve one of six possible combinations of surgical site washes and/or local antibiotics. These combinations will be used during the surgery just before the surgeon closes the wound. Patients will be followed for one year after their surgery to see if they develop any infections. Despite efforts to reduce infections after total joint replacements, the number of infections continue to rise. The findings of this study will result in high-quality evidence for infection prevention after total joint replacement. These results will be used by surgeons all over the world to decrease infections after total joint replacement, improve the quality of life of patients and lead to considerable cost savings for the healthcare system.