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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 3, 436-439.
doi: 10.1302/0301-620X.85B3.12451  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Contamination during removal of cement in revision hip arthroplasty

A CADAVER STUDY USING ULTRASOUND AND HIGH-SPEED CUTTERS

M. Nogler, MD, MA, Associate Professor1; C. Lass-Flörl, MD, Associate Professor2; C. Wimmer, MD, Associate Professor1; E. Mayr, MD, Resident1; C. Bach, MD, Associate Professor1; and M. Ogon, MD, Associate Professor1

1 Department of Orthopaedic Surgery
2 Department of Hygiene, University of Innsbruck, Anichstrasse 35, A-6020-Innsbruck, Austria.

Correspondence should be sent to Dr M. Nogler.

Instruments used in surgery which rotate or vibrate at a high frequency can produce potentially contaminated aerosols. Such tools are in use in cemented hip revision arthroplasties. We aimed to measure the extent of the environmental and body contamination caused by an ultrasound device and a high-speed cutter.

On a human cadaver we carried out a complete surgical procedure including draping and simulated blood flow contaminated with Staphylococcus aureus (ATCC 12600). After cemented total hip arthroplasty, we undertook repeated extractions of cement using either an ultrasound device or a high-speed cutter. Surveillance cultures detected any environmental and body contamination of the surgical team.

Environmental contamination was present in an area of 6 x 8 m for both devices. The concentration of contamination was lower for the ultrasound device. Both the ultrasound and the high-speed cutter contaminated all members of the surgical team. The devices tested produced aerosols which covered the whole operating theatre and all personnel present during the procedure. In contaminated and infected patients, infectious agents may be present in these aerosols. We therefore recommend the introduction of effective measures to control infection and thorough disinfection of the operating theatre after such procedures.






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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General