Extension of an Aerosol Cloud produced by an Ultrasound Cement Removal System

Ultrasound devices are in use for cement extraction in cemented revision total hip arthroplasties. These instruments vibrate at a high frequency. In contact with fluids they have the potential to produce an aerosol cloud. In case of infected or colonized patients this can be a source of environmental and body contamination for the surgical team. 12 standardized cuts in cement blocks were performed with an ultrasound device. Irrigation fluid was contaminated with Staphylococcus aureus ATTC 12600. Contamination was detected using standard cultures. Bacterial growth was seen in a 5 × 7 m area. Extension was comparable to aerosol contamination produced by high speed cutters in spinal surgery as well as in hip arthroplasty, yet, concentration was lower. Ultrasound devices, such as the one tested, can produce aerosol clouds that can cover the whole operating room and potentially contaminate the surgical personnel. The same protection is necessary for everybody in the operating room for ultrasound devices as for high-speed cutters.