Finally, strict attention to laminar airflow protocol is essential,
and there can be paradoxical increases in the rates of infection if these concepts are disregarded
[12]. This paradoxical increase in the rate of infection after total knee arthroplasty can be
attributed to the positioning of the operating team (without personal isolation suits) between the
patient and the airflow unit, with subsequent entrainment of air containing particulate matter
and bacteria from the operating room personnel into the operative wound.