{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:44:54Z","timestamp":1792053894614,"version":"4.4.0"},"reference-count":24,"publisher":"EDP Sciences","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":287,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SICOT-J"],"accepted":{"date-parts":[[2026,6,24]]},"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>\n                    <jats:italic>Introduction<\/jats:italic>\n                    : Unresolved issue remains regarding which patient populations benefit from diluted povidone-iodine (PI) irrigation for preventing surgical-site infection (SSI)\/periprosthetic joint infection (PJI) after primary total hip arthroplasty (THA). We aimed to clarify the clinical effect of diluted PI lavage on SSI\/PJI incidence in risk-stratified patients undergoing primary THA.\n                    <jats:italic>Methods<\/jats:italic>\n                    : This retrospective, single-center study included 1,128 patients with primary THA for osteoarthritis. We classified all enrolled patients into three groups according to the American Society of Anesthesiologists Physical Status (ASA-PS) 1, 2, and 3 groups. We compared the incidence rate of SSI\/PJI between two subgroups in each group: patients who received diluted PI and those who did not. Odds ratios (ORs) for SSI\/PJI were estimated for PI irrigation.\n                    <jats:italic>Results<\/jats:italic>\n                    : Eleven infections occurred overall (0.9%): five superficial SSIs (0.4%) and six early PJIs (0.5%). No infections occurred among patients in the ASA-PS 1 group. In the ASA-PS 2 group, eight SSI\/PJI events were observed (0.8%), and in ASA-PS 3, three SSI\/PJI events occurred (3.3%). In the ASA-PS 2 group, PI use was associated with a lower infection rate (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.04), whereas no significant difference was detected in ASA-PS 3 (\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.55). OR revealed that diluted PI caused a significant reduction in SSI\/PJI (OR, 0.23;\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.03) in the ASA-PS 2 group.\n                    <jats:italic>Discussion<\/jats:italic>\n                    : In this cohort, dilute PI lavage was associated with fewer SSI\/PJI events among patients with ASA-PS class 2 who underwent primary THA; however, a clear benefit was not demonstrated in patients with ASA-PS class 3. Additional intraoperative measures may be required for higher-risk patients, such as those with ASA-PS class 3.\n                  <\/jats:p>","DOI":"10.1051\/sicotj\/2026054","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:55:35Z","timestamp":1792050935000},"page":"73","source":"Crossref","is-referenced-by-count":0,"title":["Risk-stratified association between dilute povidone-iodine lavage and SSI\/PJI after primary total hip arthroplasty"],"prefix":"10.1051","volume":"12","author":[{"given":"Daisuke","family":"Inoue","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamon","family":"Kabata","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Yanagi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musashi","family":"Ima","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Iyobe","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Fujimaru","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Sano","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rin","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taisuke","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Demura","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"250","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","first-page":"3003","DOI":"10.1007\/s11999-012-2323-6","volume":"470","author":"Devane","year":"2012","journal-title":"Clin Orthop Relat Res."},{"key":"R2","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s11999-009-1157-3","volume":"468","author":"Corten","year":"2010","journal-title":"Clin Orthop Relat Res."},{"key":"R3","doi-asserted-by":"crossref","first-page":"5967","DOI":"10.1016\/j.biomaterials.2012.05.031","volume":"33","author":"Arciola","year":"2012","journal-title":"Biomaterials"},{"key":"R4","doi-asserted-by":"crossref","first-page":"147","DOI":"10.3109\/17453674.2014.966290","volume":"86","author":"Gbejuade","year":"2015","journal-title":"Acta Orthop."},{"key":"R5","unstructured":"Global Guidelines on the Prevention of Surgical Site Infection (WHO), http:\/\/www.who.int\/gspc\/ssi-guideline\/en\/."},{"key":"R6","unstructured":"Proceeding of the Second International Consensus Meeting (ICM) on Musculoskeletal Infection. Available, https:\/\/icmphilly.com\/pdf."},{"key":"R7","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1186\/s12891-023-06548-x","volume":"24","author":"Ebrahimzadeh","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"issue":"4","key":"R8","doi-asserted-by":"crossref","first-page":"613","DOI":"10.52628\/89.4.10486","volume":"89","author":"Manzotti","year":"2023","journal-title":"Acta Orthop Belg"},{"key":"R9","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.jhin.2025.02.021","volume":"160","author":"Yang","year":"2025","journal-title":"J Hosp Infect"},{"key":"R10","unstructured":"CDC (2013) NHSN Surveillance Definition of Healthcare-Associated Infection and Criteria for Specific Types of Infection in the Acute Care Setting. Hyattsville, Maryland: Centers for Disease Control and Prevention, http:\/\/www.cdc.gov\/nhsn\/PDFs\/pscManual\/17pscNosInfDef_current.pdf."},{"key":"R11","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/j.arth.2018.02.078","volume":"33","author":"Parvizi","year":"2018","journal-title":"J Arthroplast"},{"key":"R12","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/bmt.2012.244","volume":"48","author":"Kanda","year":"2013","journal-title":"Bone Marrow Transplant"},{"key":"R13","doi-asserted-by":"crossref","first-page":"189","DOI":"10.5194\/jbji-6-189-2021","volume":"6","author":"Siddiqi","year":"2021","journal-title":"J Bone Jt Infect"},{"key":"R14","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.arth.2021.10.026","volume":"37","author":"Shohat","year":"2022","journal-title":"J Arthroplasty"},{"key":"R15","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.1007\/s00402-022-04451-z","volume":"143","author":"Muwanis","year":"2023","journal-title":"Arch Orthop Trauma Surg."},{"key":"R16","doi-asserted-by":"crossref","first-page":"2458","DOI":"10.1016\/j.arth.2025.02.037","volume":"40","author":"Machinski","year":"2025","journal-title":"J Arthroplast"},{"key":"R17","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.2106\/JBJS.18.01285","volume":"101","author":"Hernandez","year":"2019","journal-title":"J Bone Joint Surg Am"},{"key":"R18","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1016\/j.arth.2019.12.035","volume":"35","author":"Slullitel","year":"2020","journal-title":"J Arthroplast"},{"key":"R19","doi-asserted-by":"publisher","first-page":"1933","DOI":"10.1016\/j.arth.2020.02.060","volume":"35","author":"Iorio","year":"2020","journal-title":"J Arthroplast"},{"key":"R20","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.jos.2022.11.013","volume":"29","author":"Martin","year":"2024","journal-title":"J Orthop Sci"},{"key":"R21","doi-asserted-by":"crossref","first-page":"S487","DOI":"10.1016\/j.arth.2025.04.084","volume":"40","author":"Saba","year":"2025","journal-title":"J Arthroplast"},{"key":"R22","doi-asserted-by":"publisher","first-page":"101067","DOI":"10.1016\/j.artd.2022.10.017","volume":"19","author":"Kawano","year":"2023","journal-title":"Arthroplast Today"},{"key":"R23","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1186\/s13018-023-03868-5","volume":"18","author":"Shirai","year":"2023","journal-title":"J Orthop Surg Res"},{"issue":"Supplement B","key":"R24","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1302\/2633-1462.66.BJO-2025-0004.R1","volume":"6","author":"Ding","year":"2025","journal-title":"Bone Jt Open"}],"container-title":["SICOT-J"],"original-title":[],"link":[{"URL":"https:\/\/www.sicot-j.org\/10.1051\/sicotj\/2026054\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:55:45Z","timestamp":1792050945000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.sicot-j.org\/10.1051\/sicotj\/2026054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":24,"alternative-id":["sicotj260003"],"URL":"https:\/\/doi.org\/10.1051\/sicotj\/2026054","relation":{},"ISSN":["2426-8887"],"issn-type":[{"value":"2426-8887","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]}}}