Comparison of Pulsed Lavage Versus Manual Pressurised Lavage in Preventing Postoperative Infection Rate in Total Knee Arthroplasty

Abstract

Objective: To compare the effectiveness of pulsed lavage versus manual pressurized lavage in preventing postoperative infection, as measured by CRP levels and clinical outcomes, in patients undergoing TKA. 
Study Design: Prospective observational cohort study 
Place and Duration of Study: This study was conducted at the Shifa International Hospital Islamabad during August 2024 till January 2025. 
Methods: A total of 173 patients undergoing TKA were included and divided into two groups based on the type of lavage used: pulsed lavage (n = 87) and manual pressurized lavage (n = 86). Data were collected using validated questionnaires during hospitalization and follow-up visits. CRP levels were recorded on postoperative Day 3, Week 2, and Week 6. Clinical signs of infection and recovery parameters were also assessed. 
Results: CRP elevations were observed in 6 patients (3 in each group), with no significant differences in mean CRP levels at any time point (p > 0.05). No clinical infections were reported in either group. Healing time, pain scores, and patient satisfaction were comparable between groups. There were no statistically significant differences in postoperative outcomes or infection-related markers. 
Conclusion: It is concluded that pulsed lavage and manual pressurized lavage are equally effective in preventing postoperative infections in TKA. Both techniques demonstrated similar inflammatory responses and recovery outcomes. Therefore, the choice of lavage method may be guided by availability, cost, and surgeon preference rather than clinical advantage.