Current Evidence for the Use of Laminar Flow in Reducing Infection Rates in Total Joint Arthroplasty

M James, W.S Khan, M.R Nannaparaju, J.S Bhamra*, R Morgan-Jones
Cardiff & Vale Orthopaedic Centre, Llandough University Hospital, Cardiff & Vale NHS Trust, Cardiff, UK

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© James et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Bone Tumour Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK; Tel: +44 (0) 20 8954 2300; Fax: +44 (0) 20 8954 2301; E-mail:


Since the introduction of laminar air flow in orthopaedic theatres by Sir John Charnley, it has widely become accepted as the standard during orthopaedic procedures such as joint arthroplasty. We present a review of available current literature for the use of laminar flow operating theatre ventilation during total joint arthroplasty and examines the effectiveness of laminar flow ventilated operating theatres in preventing post-operative wound infection. Results of our findings suggest that while bacterial and air particulate is reduced by laminar air flow systems, there is no conclusive effect on the reduction of post-operative wound infections following total joint arthroplasty. We conclude that a combination of strict aseptic technique, prophylactic antibiotics and good anaesthetic control during surgery remains crucial to reduce post-operative surgical infections.

Keywords: Arthroplasty, evidence, infection, laminar flow.