Intrawound (local) antibiotic prophylaxis as an adjunct to systemic antibiotics to prevent periprosthetic joint infection (PJI) after total hip arthroplasty: a meta-analysis of cohort studies

There is limited evidence, with a possible risk of publication bias, suggesting that intrawound (local) antibiotic prophylaxis, when added to standard systemic antibiotics, may be associated with reduced postoperative PJI after THA across primary and revision procedures. Evidence for superficial SSI and safety remains limited by few contributing studies. Standardized, head-to-head randomized trials are needed to define optimal regimens (agent, dose, timing) and long-term safety (including antimicrobial resistance).