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*Email: doconnor2@uh.eduPostoperative sepsis is a costly and potentially devastating problem in total joint arthroplasty.Airborne bacteria and other viable microorganisms shed from surgical staff are a source of deepprosthetic infection, and the density of airborne bacteria is correlated with the rate ofpostoperative joint sepsis in total joint arthroplasty surgery. Previous studies have also reporteda positive relationship between the density of nonviable airborne particulate and viable CFUcounts, both airborne and in the surgical wound, during surgery. The purpose of this study wasto determine the extent to which a system that delivers a small field of local, directed HEPAfilteredair flow over the surgical field reduces airborne particulate and airborne bacteria duringtotal hip arthroplasty. A minimum of 8 subjects per group provided 80% power (α = 0.05) todetect a ≥75% difference in bacterial density between groups. All patients who consented toundergo primary total hip arthroplasty were eligible. Thirty-six patients were prospectivelyrandomized into three groups: directed air flow, air flow system present but turned off (sham),and control (standard) conditions. Airborne particulate and bacteria were continuously collectedin consecutive 10 minute intervals within 5 cm of the surgical wound using an air samplingdevice. Data were analyzed using a generalized linear model for repeated measures. Particulatecounts and bacterial density at the surgical site were 80% lower on average in the directed airflow group compared to the other two groups (p10μm in diameter was strongly related to bacterial density at the surgical site (p