Efficacy of Taurolidine Irrigation in Primary Total Knee Arthroplasty

Abstract

PurposeTaurolidine is an antimicrobial agent that was originally used in the local treatment of peritonitis. The aim of this study was to evaluate the efficacy of taurolidine irrigation in primary total knee arthroplasty (TKA).Materials and MethodsAll patients who underwent TKA at our institute from January 2015 to March 2017 were eligible. There were 300 patients in the taurolidine irrigation group and 300 patients in the control group. The patients in the taurolidine irrigation group were irrigated after implantation with a mix of 250 mL of taurolidine and 750 mL of normal saline. The patients in the control group were not irrigated after implantation. We compared postoperative C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and infection rate between groups.ResultsThe taurolidine irrigation group had a significantly lower CRP (5.39 mg/dL vs. 7.55 mg/dL; p<0.001) and ESR (53.21 mm/hr vs. 58.74 mm/hr; p=0.003) on postoperative day 3 after TKA, as compared with the control group. However, there was no difference between the two groups on postoperative days 6, 13, and 20. Periprosthetic joint infection occurred in one patient in the taurolidine irrigation group.ConclusionsWe believe that it is not necessary to use taurolidine for patients who undergo primary TKA.

Irrigation Solutions in Total Joint Arthroplasty

“…The single TKA infection seen in the 600 patients occurred in the taurolidine group. 54 The results of this study do not support the use of taurolidine to prevent infection in hip and knee arthroplasty.…”

Editorial commentary: efficacy of taurolidine irrigation during arthroscopic debridement for bacterial septic knee arthritis

“…Among them, the fundamental treatment is inflamed tissue removal with arthroscopic debridement [3]. Some studies have introduced arthroscopic antiseptic irrigants during this procedure [4,5] However, the effect and choice of an optimal irrigation solution with antimicrobial properties and low cytotoxicity remain controversial. Taurolidine is an antimicrobial agent commonly used in general surgery to prevent intraabdominal adhesions and sepsis [6].…”