Articles   |    
Infection rates after 3175 total hip and total knee replacements performed with and without a horizontal unidirectional filtered air-flow system
EA Salvati; RP Robinson; SM Zeno; BL Koslin; BD Brause; PD Wilson
J Bone Joint Surg Am, 1982 Apr 01;64(4):525-535
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case


To determine the effect of the ventilation system on infection rates after total hip and total knee arthroplasties performed in operating rooms with and without a horizontal unidirectional filtered air-flow system, using modern antiseptic conditions and antibiotic prophylaxis, all of the single-stage procedures (3175 of a total of 4769) were subjected to statistical analysis and fifty-seven matched pairs for controls were established. A reduced infection rate after total hip replacement (from 1.4 to 0.9 per cent) and an increased infection rate after total knee replacement (from 1.4 to 3.9 per cent) were found when patients operated on in the filtered laminar air-flow operating room were compared with those whose operations were done in two conventional rooms. This pattern was statistically significant and was believed to be due to the positions of the operating team and of the wound with respect to the air flow. Prospectively accumulated factors (such as the experience of the surgeon, the duration of surgery, the diagnosis, and the patient's age) as well as retrospectively accumulated factors (such as predisposing conditions of the patient) did not explain the observed patterns of infection.

Figures in this Article
    This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    CT - Yale University School of Medicine
    OR - The Center - Orthopedic and Neurosurgical Care and Research
    PA - Penn State Milton S. Hershey Medical Center
    NY - Modern Chiropractic Care, P.C.