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Operating Room Traffic is a Major Concern During Total Joint Arthroplasty

  • Symposium: 2011 Musculoskeletal Infection Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Periprosthetic joint infection (PJI) is a challenging complication associated with total joint arthroplasty (TJA). Traffic in the operating room (OR) increases bacterial counts in the OR, and may lead to increased rates of infection.

Question/purposes

Our purposes were to (1) define the incidence of door opening during primary and revision TJA, providing a comparison between the two types of procedures, and (2) identify the causes of door opening in order to develop a strategy to reduce traffic in the operating room.

Methods

An observer collected data during 80 primary and 36 revision TJAs. Surgeries were performed under vertical, laminar flow. Operating room personnel were unaware of the observer, thus removing bias from traffic. The observer documented the number, reason, and personnel involved in the event of a door opening from time of tray opening to closure of the surgical site.

Results

The average operating time for primary and revision procedures was 92 and 161 minutes, respectively. Average door openings were 60 in primary cases and 135 in revisions, yielding per minute rates of 0.65 and 0.84, respectively. The circulating nurse and surgical implant representatives constituted the majority of OR traffic.

Conclusions

Traffic in the OR is a major concern during TJA. Revision cases demonstrated a particularly high rate of traffic. Implementation of strategies, such as storage of instruments and components in the operating room and education of OR personnel, is required to reduce door openings in the OR.

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Acknowledgments

The authors would like to thank Ranna Jaraha for her help with data collection.

Author information

Authors and Affiliations

  1. The Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA, 19107, USA

    Pedram Panahi MBBS, Mitchell Stroh BS, David S. Casper BS, Javad Parvizi MD, FRCS & Matthew S. Austin MD

Authors
  1. Pedram Panahi MBBS
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  2. Mitchell Stroh BS
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  3. David S. Casper BS
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  4. Javad Parvizi MD, FRCS
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  5. Matthew S. Austin MD
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Corresponding author

Correspondence to Matthew S. Austin MD.

Additional information

One of the authors (JP) is a consultant for Stryker Orthopaedics (Mahwah, NJ, USA) and has intellectual properties on SmarTech (Philadelphia, PA, USA)

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Panahi, P., Stroh, M., Casper, D.S. et al. Operating Room Traffic is a Major Concern During Total Joint Arthroplasty. Clin Orthop Relat Res 470, 2690–2694 (2012). https://doi.org/10.1007/s11999-012-2252-4

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  • DOI: https://doi.org/10.1007/s11999-012-2252-4

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