Splash in elective primary knee and hip replacement

• Published in: Journal of bone and joint surgery. British volume Vol. 91; no. 8; pp. 1074 - 1077
• Main Authors: SINGH, V. K, KALAIRAJAH, Y
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.08.2009; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Biological and medical sciences; Diseases of the osteoarticular system; Medical sciences; Orthopedic surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Knee; Hip prosthesis; Orthopedic surgery; Treatment; Elective; Hip
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408

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.