Shah Vikram Indrajit, Upadhyay Sachin, Shah Kalpesh, Singh Vipin
Department of Knee and Hip Arthroplasty, Shalby Hospitals, Ahmedabad, Gujarat India.
Department of Orthopaedics, NSCB Medical College, Jabalpur, MP India.
Arthroplasty. 2020;2(1):23. doi: 10.1186/s42836-020-00042-8. Epub 2020 Aug 27.
The primary purpose of the present study was to assess whether use of proposed containment sheet (so called "a frugal innovation") minimizes the aerosol and splatter dispersion during total knee arthroplasty (TKA).
A total of 32 patients with knee osteoarthritis who were scheduled to undergo primary and unilateral TKA reported during the COVID-19 pandemic were enrolled into this prospective single-institution cohort study. Demographic and epidemiological data, travel and contact history were collected. Eligible cohort was randomly assigned to a study (TKA using containment sheet) group and a control group (TKA without containment sheet). Radiological and functional outcomes before operation and at the final follow-up were assessed using Western Ontario and Mc-master Universities Osteoarthritis Index score (WOMAC) and the visual analog scale (VAS). The primary outcome was the postoperative effectiveness of containment sheet and face shield, defined as the numbers of countable macroscopic aerosols and/or splatters to naked eyes. The level of significance was set at < 0.05 levels.
Present cohort was comprised of 14 men (43.75%) and 18 women (56.25%) with an average age of 65.45 ± 4.07 years (range, 62-75 years). There were no statistically significant differences with regard to baseline parameters and perioperative demographics. Functional outcomes for knee function at the last follow-up showed significant improvement in both the groups ( < 0.05). Face shield showed significant number of aerosols/splatters in control group. Highest number/concentration of aerosols/splatters was contained within the sheet.
The proposed containment sheet can minimize the dispersion of aerosols and splatters generated during TKA and provide a safe healthcare environment in a cost-effective manner.
本研究的主要目的是评估使用建议的围手术单（即所谓的“节俭创新”）是否能在全膝关节置换术（TKA）过程中最大限度地减少气溶胶和飞沫的扩散。
本前瞻性单机构队列研究纳入了在2019年冠状病毒病大流行期间计划接受初次单侧TKA的32例膝关节骨关节炎患者。收集了人口统计学和流行病学数据、旅行和接触史。符合条件的队列被随机分为研究组（使用围手术单的TKA）和对照组（不使用围手术单的TKA）。术前和末次随访时的放射学和功能结局采用西安大略和麦克马斯特大学骨关节炎指数评分（WOMAC）和视觉模拟量表（VAS）进行评估。主要结局是围手术单和面罩的术后有效性，定义为肉眼可见的可计数宏观气溶胶和/或飞沫的数量。显著性水平设定为<0.05。
本队列由14名男性（43.75%）和18名女性（56.25%）组成，平均年龄为65.45±4.07岁（范围62 - 75岁）。基线参数和围手术期人口统计学方面无统计学显著差异。两组在末次随访时膝关节功能的功能结局均有显著改善（<0.05）。对照组面罩显示有大量气溶胶/飞沫。围手术单内气溶胶/飞沫的数量/浓度最高。
建议的围手术单可最大限度地减少TKA过程中产生的气溶胶和飞沫的扩散，并以具有成本效益的方式提供安全的医疗环境。
