Clinical trial

Prospective Randomized Evaluation of Emerging Novel Treatments for Infection Prophylaxis in Total Joint Replacement (PREVENT-iT)

Name
PiT-2023
Description
Osteoarthritis (OA) is the most common cause of disability in older adults worldwide affecting 7% of the global population, or more than 500 million people globally. Total joint replacements (TJR) can help bring relief to those with osteoarthritis when other treatment options are no longer helpful. Infection is the main reason hip and knee replacements "fail". Failure leads to repeat surgeries that are often more complicated and less likely to be successful than the first surgery. Reducing the risk of infection is extremely important, antiseptic washes and antibiotics may help us do that. After joint replacement surgery, orthopaedic surgeons wash and clean the surgical wound to lower the risk of infection. The goal of this clinical trial is to determine if the use of antiseptic solutions to wash the surgical site and placing an antibiotic directly into the wound will reduce the number of infections requiring reoperation. Patients having total joint replacements will be randomized (like flipping a coin) to receive 6 possible combinations of washes and / or antibiotics. Participants will be followed for one year after TJR to compare the rate of infection in each group.
Trial arms
Trial start
2024-05-01
Estimated PCD
2028-11-01
Trial end
2028-11-01
Status
Recruiting
Phase
Early phase I
Treatment
Chlorhexidine Gluconate
0.05% chlorhexidine gluconate solution for irrigation
Arms:
Chlorhexidine Gluconate 0.05% Lavage Solution, Chlorhexidine Gluconate 0.05% Lavage Solution and Vancomycin
Vancomycin Hydrochloride
2 grams of topical vancomycin hydrochloride added to the wound
Arms:
Chlorhexidine Gluconate 0.05% Lavage Solution and Vancomycin, Povidone-Iodine 0.35% Lavage Solution and Vancomycin, Saline Lavage Solution and Vancomycin
Povidone-Iodine
0.35% povidone-iodine solution for irrigation
Arms:
Povidone-Iodine 0.35% Lavage Solution, Povidone-Iodine 0.35% Lavage Solution and Vancomycin
Saline
saline for irrigation
Arms:
Saline Lavage Solution, Saline Lavage Solution and Vancomycin
Size
21006
Primary endpoint
The number of reoperations due to infection
Within 1 year of total joint replacement
Eligibility criteria
Inclusion Criteria: 1. Patients 18 years of age or older. 2. Undergoing primary or aseptic revision TJR. 3. No contraindications to study interventions. 4. Informed consent (participant or substitute decision maker) obtained and willing to comply with the protocol. Exclusion Criteria: 1. Received antibiotics for any reason in the two weeks prior to their TJR. 2. Chronic or acute infection at or near the TJR site. 3. Prior history of periprosthetic joint infection including any reoperation due to infection. 4. Undergoing surgery for a diagnosis of a fracture. 5. Open infected wounds on affected limb. 6. Undergoing bilateral TJR. 7. Currently enrolled in a study that does not permit co-enrollment. 8. Prior enrollment in the trial including the pilot study 9. Any condition or circumstance, which in the opinion of the Investigator, interferes with assessments or completion of the trial.
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE3'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'FACTORIAL', 'primaryPurpose': 'PREVENTION', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 21006, 'type': 'ESTIMATED'}}
Updated at
2024-06-03

1 organization

2 products

1 indication

Product
Vancomycin