In‐Room Ultraviolet Air Filtration Units Reduce Airborne Particles During Total Joint Arthroplasty

Reducing airborne bioburden in total joint arthroplasty (TJA) is of critical importance. The efficacy of crystalline ultraviolet‐C (C‐UVC) filtration in reducing bioburden in a dynamic operating room (OR) environment has not been evaluated. We assessed whether C‐UVC filtration reduced (i) total particle counts (TPC); (ii) viable particle counts (VPC); and (iii) colony‐forming units (CFUs). Fifty primary TJA cases were performed in a positive‐pressure OR; 25 cases with the C‐UVC unit and 25 cases without. The air was sampled by a particle counter and an impact air sampler to measure particle counts and CFUs, respectively. To compare TPC, VPC, and CFU/m³ between groups, independent t tests and multivariate regression, adjusted for number of OR staff and door openings, were performed. The C‐UVC group had significantly lower TPC (2.6 × 10⁶ vs. 4.7 × 10⁶ particles, p = 0.001) and VPC (18,605 vs. 27,516 particles, p = 0.001). There were fewer CFUs in the C‐UVC group (10.9 CFU/m³ vs. 13.7 CFU/m³, p = 0.163). Multivariate analysis identified C‐UVC filtration as a significant predictor of decreased TPC (β = −0.44, p = 0.002) and VPC (β = −0.47, p = 0.001) after accounting for door openings and number of OR staff. The reduction in CFUs was not significant on multivariate analysis. In this prospective pilot study, a C‐UVC air disinfection and recirculation unit led to a significant reduction in both TPC and VPC and a non‐significant reduction in CFU. Statement of clinical significance: Further studies are needed to investigate the effects of C‐UVC filtration units on surgical‐site infection rates. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:431‐437, 2020