Pulse lavage is inadequate at removal of biofilm from the surface of total knee arthroplasty materials

Kenneth L. Urish, Peter W. DeMuth, David W. Craft, Hani Haider, Charles M. Davis

Research output: Contribution to journalArticle

29 Scopus citations


In acute periprosthetic infection, irrigation and debridement with component retention has a high failure rate in some studies. We hypothesize that pulse lavage irrigation is ineffective at removing biofilm from total knee arthroplasty (TKA) components. Staphylococcus aureus biofilm mass and location was directly visualized on arthroplasty materials with a photon collection camera and laser scanning confocal microscopy. There was a substantial reduction in biofilm signal intensity, but the reduction was less than a ten-fold decrease. This suggests that irrigation needs to be further improved for the removal of biofilm mass below the necessary bioburden level to prevent recurrence of acute infection in total knee arthroplasty.

Original languageEnglish (US)
Pages (from-to)1128-1132
Number of pages5
JournalJournal of Arthroplasty
Issue number6
StatePublished - Jun 2014



  • Biofilm
  • Periprosthetic joint infection
  • Pulse lavage
  • Single stage irrigation debridement
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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