ReviewJournal of clinical medicine2025
Advances in Orthopedic Surgery Irrigation: A Review of Traditional Agents and the Emergence of Citrate-Based Solutions.
Review in Journal of clinical medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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
4 citing papers in PubMed.
- Tactical use of irrigants in open orthopaedic procedures: 'what to use & when'.EFORT open reviews · 2026Review
- Strategic considerations in the treatment of infected nonunion in the lower extremity: a narrative review.International journal of surgery (London, England) · 2026Article
- Patient-reported outcomes after total knee arthroplasty with xperience vs. standard irrigation: a retrospective cohort study.Journal of orthopaedic surgery and research · 2025Article
- Irrigation Solutions in Wound Care and Breast Surgery: Evidence-Based Applications, Regulatory Considerations, and Future Directions.Journal of clinical medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Surgical site infections (SSIs) and prosthetic joint infections (PJIs) remain significant challenges in orthopedic surgery, particularly in joint arthroplasty. Intraoperative irrigation is a widely used strategy for infection prevention, yet traditional solutions such as saline, povidone-iodine, hydrogen peroxide, and sodium hypochlorite are limited by cytotoxicity, short antimicrobial duration, and poor biofilm penetration. This review evaluates commonly used irrigation agents and highlights the growing evidence supporting a novel citrate-based solution as a potentially superior alternative. These agents combine broad-spectrum antimicrobial activity, effective biofilm disruption through ionic chelation, and prolonged postoperative protection with minimal harm to host tissues. Early clinical studies and ongoing randomized trials have demonstrated promising results, including reductions in postoperative swelling, opioid use, and infection rates. As more data become available, citrate-based solutions may emerge as the preferred standard for intraoperative irrigation in orthopedic procedures.
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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.