Saline Irrigation Shows Similar Infection Rates to Other Solutions in Total Hip Arthroplasty
Published: March 4, 2026
New Orleans – A recent study presented at the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting suggests that saline irrigation during total hip arthroplasty (THA) demonstrates comparable infection rates to other commonly used irrigation solutions, including dilute povidone-iodine, vancomycin powder and a combination of both.
Study Details and Findings
Researchers, led by Joshua C. Rozell, MD, of NYU Langone Orthopedics, and Olivia Schaffer, BS, conducted a randomized trial involving 821 patients undergoing THA who were identified as being at high risk for periprosthetic joint infection (PJI). Patients were randomly assigned to receive one of four irrigation protocols:
- Vancomycin powder alone
- Dilute povidone-iodine lavage
- A combination of vancomycin powder and dilute povidone-iodine
- Saline irrigation
The study found similar risks for PJI across all four groups. Specifically, infection rates were:
- 0.5% for vancomycin
- 1.7% for iodine
- 1.9% in the combination protocol
- 1.1% in the saline group
Implications for Surgical Practice
According to Dr. Rozell, these findings indicate that the specific type of irrigation solution used during THA does not significantly impact PJI rates. He emphasized the importance of thorough irrigation, sterile technique, and minimizing operative time as key factors in preventing infection.
“As long as you are performing adequate irrigation and doing it early and often throughout the case in large volumes, I do not necessarily suppose it matters what you are irrigating with,” Dr. Rozell stated. “What is more vital is frequent irrigation, maintaining sterile technique throughout the case and limiting operative time and the wound being open.”
Study Details and Disclosures
The research was presented as Paper 200 at the AAOS Annual Meeting, held March 2-6, 2026, in New Orleans.
Source: Saba BV, et al. Paper 200. Presented at American Academy of Orthopaedic Surgeons Annual Meeting; March 2-6, 2026; New Orleans.
Disclosures: Dr. Rozell reports no relevant financial disclosures. Ms. Schaffer reports receiving support from ThinkSono.