Study Questions Whether Laminar Air Flow Increases Risk Of Joint Replacement Surgery Infections

Although it has been thought laminar air flow (LAF) in operating rooms is vital to keeping infectious agents out of open surgical wounds and avoiding knee and hip replacement infections, the findings of a new study suggest the systems may not play a significant in actually preventing joint replacement infections.

In findings published in the medical journal JAMA Network Open published on October 16, researchers from China and the U.S. indicate that, even when done correctly, laminar airflow failed to reduce rates of infections among patients undergoing prosthetic joint surgery.

Laminar air flow is commonly used in operating rooms involving positive pressure air currents through filtration units, which is designed to direct air streams away from the operative flow and generate a continuous flow of bacteria free air. The aim of the systems is to reduce the number of infective organism in the air around open surgical wounds, reducing the risk of infections that can have devastating impact on the surgical outcomes.

The retrospective cohort study involved nearly 7,000 patients who underwent either primary total knee arthroplasty or total hip arthroplasty at two different surgical sites from January 2013 to September 2017, with a one-year minimum follow-up. The surgeries were either done in a room equipped with laminar air flow or one with a turbulent airflow.

According to the findings, the incidence of periprosthetic joint infection (PJI) were similar regardless of which airflow technique was used. They concluded laminar airflow was not linked to a lower risk of infections.

“This study suggests that the use of LAF in the operating room was not associated with a reduced incidence of PJI after primary total joint arthroplasty,” the researchers concluded. “With an appropriate perioperative protocol for infection prevention, LAF does not seem to play a protective role in PJI prevention.”