Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2024; 15(3): 293-301
Published online Mar 18, 2024. doi: 10.5312/wjo.v15.i3.293
Pulsed lavage in joint arthroplasty: A systematic review and meta-analysis
Mohammad Daher, Gaby Haykal, Marven Aoun, Marc Moussallem, Ali Ghoul, Jean Tarchichi, Amer Sebaaly
Mohammad Daher, Gaby Haykal, Marven Aoun, Marc Moussallem, Ali Ghoul, Jean Tarchichi, Amer Sebaaly, Department of Orthopedics, Saint Joseph University, Beirut 1001, Lebanon
Author contributions: Daher M contributed to writing draft; Haykal G contributed to editing; Haykal G and Sebaaly A contributed to supervision; Aoun Mand Moussallem M contributed to data collection; Aoun M, Moussallem M, Ghoul A, Tarchichi J, and Sebaaly A contributed to writing; Sebaaly A contributed to editing.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammad Daher, BSc, MD, Doctor, Department of Orthopedics, Saint Joseph University, Damascus Street Beirut Lebanon, Beirut 1001, Lebanon. mohdaher06@gmail.com
Received: December 14, 2023
Peer-review started: December 14, 2023
First decision: December 23, 2023
Revised: December 26, 2023
Accepted: February 8, 2024
Article in press: February 8, 2024
Published online: March 18, 2024
Abstract
BACKGROUND

Knee and hip osteoarthritis affects millions of people around the world and is expected to rise even more in frequency as the population ages. Joint arthroplasty is the surgical management of choice in these articulations. Heterotopic ossification and radiolucent lines formation are two frequent problems faced in hip and knee replacements respectively. Some studies show that the usage of pulsed lavage may prevent their formation.

AIM

To compare pulsed lavage to standard lavage in joint arthroplasty.

METHODS

PubMed, Cochrane, and Google Scholar (page 1-20) were searched till December 2023. Only comparative studies were included. The clinical outcomes evaluated were the heterotopic ossification formation in hip replacements, radiolucent lines formation, and functional knee scores in knee replacements.

RESULTS

Four studies met the inclusion criteria and were included in this meta-analysis. Pulsed lavage was shown to reduce the formation of radiolucent lines (P = 0.001). However, no difference was seen in the remaining outcomes

CONCLUSION

Pulsed lavage reduced the formation of radiolucent lines in knee replacements. No difference was seen in the remaining outcomes. Furthermore, the clinical significance of these radiolucent lines is poorly understood. Better conducted randomized controlled studies and cost-effectivity studies are needed to reinforce these findings.

Keywords: Knee arthroplasty, Hip arthroplasty, Pulsed lavage, Syringe lavage, Heterotopic ossification, Radiolucent lines

Core Tip: Pulsed lavage may be important in total knee arthroplasty but has no added benefit in total hip arthroplasty.