PPJJournal of Perioperative Practice1750-45892515-7949SAGE PublicationsSage UK: London, England10.1177/1750458921101562910.1177_17504589211015629Review ArticleThe role of acetic acid in orthopaedic surgeryhttps://orcid.org/0000-0002-0847-4898HashmiYousuf1ZhouAndrew Kailin23JawaidAnam1ZhouAnli Yue4ShahVianca5ThahirAzeem2KrkovicMatija2College of Medical and Dental Sciences, University of Birmingham, School of Medicine, Birmingham, UKDepartment of Trauma and Orthopaedics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, Cambridge, UKSchool of Clinical Medicine, University of Cambridge, Cambridge, UKSchool of Health Sciences, University of Manchester, Manchester, UK Natural Science Department, University of Cambridge, Cambridge, UK

These authors contributed equally as first authors.

Yousuf Hashmi, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. Email: ysh648@student.bham.ac.uk
2672021326162166© The Author(s) 20212021Association for Perioperative Practicehttps://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

Acetic acid has become more commonly used in orthopaedic surgery. The purposed roles include biofilm eradication and surgical debridement, postoperative scar reduction and managing soft tissue injuries. Current research is scarce and does not provide conclusive evidence behind acetic acid’s efficacy in orthopaedic procedures such as biofilm eradication or acetic acid iontophoresis in soft tissue injuries. Current literature on acetic acid’s effects on biofilm eradication is composed of in-vitro studies, which do not demonstrate the potential clinical efficacy of acetic acid. Acetic acid iontophoresis is a novel technique which is now more commonly accepted for soft tissues injuries. Our literature search identified calcifying tendonitis of the shoulder, rotator cuff tendinopathy, heel pain syndrome, plantar fasciitis, achilles tendonitis, calcifying tendonitis of the ankle, myositis ossificans and cervical spondylosis as documented clinical uses. In this narrative review, we present the current uses of acetic acid and acetic acid iontophoresis, while evaluating the evidence revolving around its efficacy, benefits and risks.

IontophoresisDebridementSoft tissue injuriestypesetterts1