ArticleCMAJ open
Postoperative antibiotic prophylaxis in total hip and knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Comparative effectiveness of antibiotic prophylaxis for preventing serious adverse events after primary total hip arthroplasty: a systematic review and network meta-analysis of randomized trials.Acta orthopaedica · 2025Pooled it
- Is There a Difference in Infection Risk Between Single and Multiple Doses of Prophylactic Antibiotics? A Meta-analysis.Clinical orthopaedics and related research · 2019Pooled it
- Causes and Frequencies of Reoperations After Endoprosthetic Reconstructions for Extremity Tumor Surgery: A Systematic Review.Clinical orthopaedics and related research · 2019Pooled it
- Comparison of Prophylactic Intravenous Antibiotic Regimens After Endoprosthetic Reconstruction for Lower Extremity Bone Tumors: A Randomized Clinical Trial.JAMA oncology · 2022Trial
- Single- vs Multiple-Dose Antibiotic Prophylaxis for Total Hip Arthroplasty.JAMA network open · 2026Article
- Coordinated control of miniature magnetic pumps for liquid sampling and delivery in a knee implant.Device · 2026Article
- Extended oral antibiotic prophylaxis does not reduce periprosthetic joint infection after primary outpatient total shoulder arthroplasty: A matched cohort analysis.Shoulder & elbow · 2026Article
- Preoperative Risk Factors and Phenotypic Clustering in Periprosthetic Joint Infection: A Matched Case-Control Study.Life (Basel, Switzerland) · 2025Article
- Article
- Infection prevention strategies in shoulder surgery: A survey of fellowship-trained shoulder surgeons.Shoulder & elbow · 2025Article
- Article
- Systemic antibiotic prophylaxis in arthroplasty - a narrative review of how many doses are optimal.EFORT open reviews · 2024Review
- Article
- Observational
- Antibody-Drug Conjugates to Treat Bacterial Biofilms via Targeting and Extracellular Drug Release.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2023Article
- Introducing A Day-Case Shoulder Arthroplasty Pathway In The UK - How We Did It.Shoulder & elbow · 2023Article
- High Risk for Persistent Peri-Prosthetic Infection and Amputation in Mega-Prosthesis Reconstruction.Journal of clinical medicine · 2023Article
- International Survey of Practice for Prophylactic Systemic Antibiotic Therapy in Hip and Knee Arthroplasty.Antibiotics (Basel, Switzerland) · 2022Article
- Clindamycin-Based 3D-Printed and Electrospun Coatings for Treatment of Implant-Related Infections.Materials (Basel, Switzerland) · 2021Article
- Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostoperative antibiotic prophylaxis is currently the standard of care for patients undergoing total hip and knee arthroplasty. We evaluated the evidence for this practice in the reduction of surgical-site infections.
methodsWe systematically searched MEDLINE, Embase and the Cochrane Library for randomized controlled trials (RCTs) published up to Aug. 15, 2014. We included all RCTs that compared postoperative antibiotic prophylaxis with postoperative placebo or no treatment in patients undergoing primary total hip or knee arthroplasty for osteoarthritis. We combined outcomes for surgical-site infection using a random-effects model and quantified heterogeneity using the χ2 test and the I2 statistic. We assessed the overall quality of the evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
resultsWe identified 4 RCTs (n = 4036) that met the inclusion criteria. Surgical-site infections occurred in 3.1% (63/2055) of patients in the prophylaxis group and 2.3% (45/1981) in the control group. Postoperative prophylaxis did not reduce the rate of surgical-site infections compared with placebo (risk difference 0.01, 95% confidence interval 0.00 to 0.02; I2 = 26%). This result was robust to sensitivity testing for losses to follow-up. According to the GRADE approach, the overall quality of evidence was very low.
interpretationThe available evidence did not show efficacy of postoperative antibiotic prophylaxis for the prevention of surgical-site infections in patients undergoing total hip or knee arthroplasty. Multicentred RCTs are likely to have an important impact on the confidence in the effect estimate and to change the estimate itself.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.