Single-Use Instrumentation, Cutting Blocks, and Trials Decrease Contamination during Total Knee Arthroplasty: A Prospective Comparison of Navigated and Nonnavigated Cases

Michael A. Mont; Aaron J. Johnson; Kimona Issa; Robert Pivec; Kurt E. Blasser; David McQueen; Lalit Puri; Daniel A. Dethmers; David W. Miller; Philip H. Ireland; John R. Shurman; Petter Bonutti

doi:10.1055/s-0033-1333664

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2013; 26(04): 285-290
DOI: 10.1055/s-0033-1333664

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Single-Use Instrumentation, Cutting Blocks, and Trials Decrease Contamination during Total Knee Arthroplasty: A Prospective Comparison of Navigated and Nonnavigated Cases

Michael A. Mont

¹Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland

,

Aaron J. Johnson

¹Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland

,

Kimona Issa

¹Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland

,

Robert Pivec

¹Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland

,

Kurt E. Blasser

²Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida

,

David McQueen

³Department of Orthopedic Surgery, Kansas University, Kansas City, Kansas

,

Lalit Puri

⁴Department of Orthopedic Surgery, Northwestern Memorial Hospital, Chicago, Illinois

,

Daniel A. Dethmers

⁵Department of Orthopedic Surgery, Bonutti Orthopedic Services, LTD, Effingham, Illinois

,

David W. Miller

⁶Department of Orthopedic Surgery, West End Orthopedic Clinic, Richmond, Virginia

,

Philip H. Ireland

⁷Department of Orthopedic Surgery, Indiana University, Fishers, Indiana

,

John R. Shurman

⁸Department of Orthopedic Surgery, University of Kansas Wichita, Wichita, Kansas

,

Petter Bonutti

⁵Department of Orthopedic Surgery, Bonutti Orthopedic Services, LTD, Effingham, Illinois

› Author Affiliations

Abstract

The purpose of this prospective controlled trial was to determine whether decrease in contamination could be achieved in nonnavigated and navigated total knee arthroplasties by replacing traditional saws, cutting blocks, and trials with specialized saws and single-use cutting blocks and trials. Various tray wrapping metrics during total knee arthroplasty were measured in 400 procedures performed by 8 different surgeons at 6 institutions. Instrumentation contamination was determined by counting the number of tray sterility indicators, pans, and instruments that were compromised. The results show that a decrease in contamination was evident in 57% (nonnavigated) and 32% (navigated) fewer compromises of tray sterility indicators, pans, and instruments. Single-use instruments show promising benefits, but further study is needed to confirm safety and efficacy before they can be widely adopted. The authors believe that the use of single-use instruments, cutting guides, and trial implants for total knee arthroplasty will play an increasing role in decreasing operating room contamination and potential deep infections.

Keywords

total knee arthroplasty - single-use instruments - cutting block - contamination - time saving

Full Text

References

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