2026 AAHKS Annual Meeting: Cyclic Local Antibiotic Irrigation for PJI: 24-Month Treatment Outcomes

152 patients with chronic hip or knee periprosthetic joint infection (PJI) who underwent implant explantation were randomized to receive the cyclic, local, expedited antibiotic-irrigation regimen (CLEAR) using VT-X7 (n=76) or conventional two-stage exchange arthroplasty (n=76). The primary outcome was treatment success, defined as infection control with permanent reimplantation, no reoperation, no recurrent PJI, survival, and no suppressive antibiotic use. Secondary outcomes included reimplantation rate, time to reimplantation, operative time, unplanned septic reoperations, and mortality. Outcomes were assessed up to 24 months. Overall, the results revealed significantly higher treatment success with CLEAR compared with two-stage exchange arthroplasty, alongside faster reimplantation, shorter operative time, and fewer unplanned septic reoperations. These findings suggested that cyclic local antibiotic irrigation may offer an effective alternative to conventional two-stage exchange for chronic PJI.