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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 8, 1074-1077.
doi: 10.1302/0301-620X.91B8.22079  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Splash in elective primary knee and hip replacement

ARE WE ADEQUATELY PROTECTED?

V. K. Singh, DOrtho, MRCS, MCh(Orth), Clinical Fellow in Trauma and Orthopaedics1; and Y. Kalairajah, MA(Cantab), MPhil, FRCS(Orth), Consultant in Trauma and Orthopaedics1

1 Luton and Dunstable Hospitals, NHS Foundation Trust, Lewsey Road, Luton LU4 0DZ, UK.

Correspondence should be sent to Mr V. K. Singh; e-mail: orthopaediks{at}googlemail.com

An intra-operative splash is a common occurrence in elective knee and hip replacement surgery and can potentially transmit bloodborne diseases, with devastating consequences. This study aimed to quantify the risk of a splash and to assess its correlation with body mass index, duration of surgery and the volume of lavage fluid used.

Between December 2007 and April 2008, 62 consecutive patients (38 women, 24 men) undergoing an elective total knee or total hip replacement (TKR, THR) were recruited into the study (32 TKRs and 30 THRs) after appropriate consent.

A splash occurred in all 62 cases. A THR had a slightly higher risk of a splash than a TKR, but this was not statistically significant (p = 0.27). The correlation between body mass index, duration of surgery and the amount of pulse lavage used with a splash was r = 0.013, (non-significant), r = 0.52, (significant) and r = 0.92 (highly significant), respectively.

A high number of splashes are generated during a TKR and a THR. The simple visor mask fails to protect the surgeon, the assistant or the patient from the risk of a splash and reverse splash, respectively.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General