Technical Innovation in Critical Care in a World of Constraints: Lessons from the COVID-19 Pandemic.

The COVID-19 crisis was characterized by a massive need for respiratory support, which has unfortunately not been met globally. This situation mimicked those which gave rise to critical care in the past. Since the polio epidemic in the 50's, the technological evolution of respiratory support has enabled health professionals to save the lives of critically-ill patients worldwide every year. However, much of the current innovation work has turned around developing sophisticated, complex, and high-cost standards and approaches whose resilience is still questionable upon facing constrained environments or contexts, as seen in resuscitation work outside intensive care units, during pandemics, or in low-income countries. Ventilatory support is an essential life-saving tool for patients with respiratory distress. It requires an oxygen source combined to a ventilatory assistance device, an adequate monitoring system, and properly trained caregivers to operate it. Each of these elements can be subject to critical constraints, which we can no longer ignore. The innovation process should incorporate them as a prima materia, whilst focusing on the core need of the field using the concept of frugal innovation. Having a universal access to oxygen and respiratory support, irrespective of the context and constraints, necessitates: i) developing cost-effective, energy-efficient, and maintenance-free oxygen generation devices; ii) improving the design of non-invasive respiratory devices (for example, with oxygen saving properties); iii) conceiving fully frugal ventilators and universal monitoring systems; iv) broadening ventilation expertise by developing end-user training programs in ventilator assistance. The frugal innovation approach may give rise to a more resilient and inclusive critical care system. This paradigm shift is essential for the current and future challenges.

Frugal Innovation a Game Changer to Sustainable Affordable Housing A Bibliometrics and Systematic Review

Globally the demand for housing is far more than supply, resulting to 100 million+ been homeless and with one billion people living in inadequate homes. In addition, recent world crisis such as high rural urban migration, natural disasters like the Syria-Turkey earth quake, flooding, conflicts such as the ongoing Russia-Urkraine war, COVID-19 protocols of social distance and isolation, etc. exacerbates the housing deficit. Whilst the current approach to housing especially in developing countries concentrates on convention unsustainable approach to affordable housing delivery. With the few sustainable housing development attempts been far luxurious beyond average Ghanaian affordability. This research seeks to contribute to address housing deficit problems using frugal Innovation (FI) as a game changer to sustainable affordable housing (SAH) through a bibliometrics and a systematic review study. With regards to financial, resource-constrained, significant cost reductions over existing options and sustainable solutions, one idea currently gaining traction is frugal innovation (FI). It is more affordable than the conventional approach to development and can convert constraint into opportunity in a sustainable manner, as well as have a direct link to sustainable affordable development. Search for this study was on all disciplines with publications linked to frugal innovation and sustainable affordable housing limited to only online articles, conference publications, books, and other materials published in English on Scopus, science direct, and Google Scholar. The finding revealed, FI is a combination of all similar innovations, under one umbrella to serve the underserved bottom-of-the-pyramid (BOP) market, making it superior to other forms of innovation. This study will contribute significantly to improving the policy direction of stakeholders in an attempt to reduce the housing deficit in Ghana and other developing countries globally. In addition, it will contribute to the UN-SDGs and UN-Habitat policymakers on the sustainable cities 2030 agenda © This open access article is published under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license. https://creativecommons.org/licenses/by-nc-nd/4.0/

Evaluation of a fast-and-frugal clinical decision algorithm ('pathways') on clinical outcomes in hospitalised patients with COVID-19 treated with anticoagulants.

RATIONALE, AIMS AND OBJECTIVES: Critics have charged that evidence-based medicine (EBM) overemphasises algorithmic rules over unstructured clinical experience and intuition, but the role of structured decision support systems in improving health outcomes remains uncertain. We aim to assess if delivery of anticoagulant prophylaxis in hospitalised patients with COVID-19 according to an algorithm based on evidence-based clinical practice guideline (CPG) improved clinical outcomes compared with administration of anticoagulant treatment given at individual practitioners' discretion. METHODS: An observational design consisting of the analysis of all acutely ill, consecutive patients (n = 1783) with confirmed COVID-19 diagnosis admitted between 10 March 2020 to 11 January 2022 to an US academic center. American Society of Haematology CPG for anticoagulant prophylaxis in hospitalised patients with COVID-19 was converted into a clinical pathway and translated into fast-and-frugal decision (FFT) tree ('algorithm'). We compared delivery of anticoagulant prophylaxis in hospitalised patients with COVID-19 according to the FFT algorithm with administration of anticoagulant treatment given at individual practitioners' discretion. RESULTS: In an adjusted analysis, using combination of Lasso (least absolute shrinkage and selection operator) and propensity score based weighting [augmented inverse-probability weighting] statistical techniques controlling for cluster data, the algorithm did not reduce death, venous thromboembolism, or major bleeding, but helped avoid longer hospital stay [number of patients needed to be treated (NNT) = 40 (95% CI: 23-143), indicating that for every 40 patients (23-143) managed on FFT algorithm, one avoided staying in hospital longer than 10 days] and averted admission to intensive-care unit (ICU) [NNT = 19 (95% CI: 13-40)]. All model's selected covariates were well balanced. The results remained robust to sensitivity analyses used to test the stability of the findings. CONCLUSIONS: When delivered using a structured FFT algorithm, CPG shortened the hospital stay and help avoided admission to ICU, but it did not affect other relevant outcomes.

Exploring the antecedents of frugal innovation and operational performance: the role of organizational learning capability and entrepreneurial orientation

Purpose: This study aimed to analyze the role of organizational learning capability and entrepreneurial orientation on frugal innovation and, consequently, operational performance within the Brazilian textile industry. Design/methodology/approach: The sample consisted of 257 valid questionnaires from the textile industry in the state of Santa Catarina, Brazil. Data were analyzed using structural equation modeling using SmartPLS software. Findings: The results showed that organizational learning capability is a strong driver of the operational performance when mediated by frugal innovation. Evidence also showed that relationships between entrepreneurial orientation, organizational learning capability, frugal innovation and operational performance are significant once the direct effect has more power than the indirect effect. Results elucidated different outcomes that are not in accordance with previously seen studies. Moreover, the latter shines a light on a possible interference caused by the COVID-19 pandemic. Originality/value: The study clarifies the relationship that entrepreneurial orientation and organizational learning capability unleash in frugal innovation and operational performance. It also shows a new situation when looking at the relationship between entrepreneurial orientation, organizational learning capability and operational performance. © 2023, Emerald Publishing Limited.

A Narrative Review of Innovative Responses During the COVID-19 Pandemic in 2020.

Objectives: The coronavirus disease 2019 (COVID-19) pandemic presented unprecedented challenges to healthcare systems worldwide. While existing studies on innovation have typically focused on technology, health providers still only have a vague understanding of the features of emergency responses during resource exhaustion in the early stage of a pandemic. Thus, a better understanding of innovative responses by healthcare systems during a crisis is urgently needed. Methods: Using content analysis, this narrative review examined articles on innovative responses during the COVID-19 pandemic that were published in 2020. Results: A total of 613 statements about innovative responses were identified from 296 articles and were grouped under the following thematic categories: medical care (n = 273), workforce education (n = 144), COVID-19 surveillance (n = 84), medical equipment (n = 59), prediction and management (n = 34), and governance (n = 19). From the four types of innovative responses extracted, technological innovation was identified as the major type of innovation during the COVID-19 pandemic, followed by process innovations, frugal innovation, and repurposing. Conclusion: Our review provides insights into the features, types, and evolution of innovative responses during the COVID-19 pandemic. This review can help health providers and society show better and quicker responses in resource-constrained conditions in future pandemics.

Frugal innovation in wound care: a critical discussion of what we can learn from low-resource settings.

Frugal innovation is a common philosophy in low-income settings due to limited access to resources. However, with both the increasing prevalence and clinical acuity of patients with wounds in the UK, it is essential that alongside innovation such as harnessing cutting-edge new technologies, frugal innovation is also pursued. This may improve both economic efficiency and patient outcomes. Frugal innovations were adopted throughout the COVID-19 pandemic and included opportunistic solutions such as video-conferencing services to run clinics. However, there are many more opportunities for frugal innovation in wound care, including the use of smartphone technology, which is already accessible to 99.5% of UK clinicians caring for wounds, or the simplification of wound-assessment processes using pulse oximeters as an alternative to dopplers, as in the Lanarkshire Oximetry Index. This article explores what frugal innovation is and how it could improve UK wound services. The authors invite clinicians working in wound care to consider their access to existing resources that may not be considered useful for wound-care processes and explore how these could be used to improve clinical outcomes.

The Effectiveness of Playful Augmented Reality Media for Teaching Early-Primary Students

Hybrid learning has become the only solution to ensure the learning process still occurs in place of traditional classroom activities during the Covid-19 pandemic. Following this condition, the phenomenon of "Zoom Fatigue" has emerged. Some of the symptoms reported are decreased learning motivation, low attention, and reduced responses. Thus, a refresher process, including the use of new playful and frugal learning media is necessary for varying children's learning activities. A learning intervention was designed to teach anatomy playfully as part of a biology curriculum. The Augmented Reality technology used in this research is a Humanoid 4D+ mobile application with flashcards, developed by Octagon Studio. This media displays information virtually on a smartphone screen when the application uses the camera to scan flashcards containing visual markers. A hybrid learning space is formed as students can see information virtually. But, physically, they are in control because they run applications and choose the type of flashcard they want to scan. The research was undertaken in several learning parks in Solo City, Central Java Province, Indonesia, with a total of 43 volunteer teachers and 132 early primary students participating. Previously, the ACES team (part of a UKRI funded project) had provided online training on the use of this media with teachers. Each teacher would then implement the media for all students in each learning park. The teachers demonstrate the media and each student takes turns running the application to view information virtually, therefore experiencing interactive learning. The qualitative approach was conducted for capturing teachers' perceptions of Augmented Reality media. A survey using the JISC online platform was distributed to capture participants' reflections on the activities and media used. Based on findings, the media appears beneficial, effective, and efficient for teaching anatomy concepts. Its virtual features can attract the children's attention and teachers do not need to bring a lot of physical teaching aids, just one application to explain all organ system concepts. Students can learn playfully on their own and feel new learning experiences. The results indicated that the intervention could create playful and frugal activities which build student engagement as a potential solution to address issues of Zoom Fatigue. The next stage of the project will involve volunteer teachers implementing the technology more widely in their classes. © 2022 Dechema e.V.. All rights reserved.

Initial Survey Validation for the Impact of Intellectual Capital on Frugal Innovation

The rapidly developing Covid-19 epidemic has resulted in nationwide lockdowns, putting many higher learning institutions (HLIs) at risk of extinction due to low profitability and limited finance. This upheaval has increased the pressure on institutions to capitalize on their intellectual resources and develop new economic models. HLIs are turning towards digital transformation as e-learning has become the new normal. This paper explains how pretest and pilot tests were used to improve the methodological reliability of research instruments and suggests that it should be a common step in research instrument development. Pretest, which consists of expert review, cognitive interviewing, and pilot testing, were carried out to manage challenges due to dissimilar context emerging from geographic, linguistic, and cultural differences as the instrument was adopted from past literature. Six professional experts were chosen for face validation, followed by a cognitive interview with 10 ten respondents from the actual respondent's list, which is the management of private university listed in SETARA Listing 2018. Pilot testing consisting of 30 respondents was conducted in the second stage to check reliability and validity. Results from expert review and cognitive interviewing allowed the researcher to quickly resolve issues based on 'respondents' feedback on the wording problems, relevance, and usability of the questionnaire. The results from the pilot test reliability analysis revealed that the scales had good internal consistency. Researchers were able to alter research instruments and enhance the research design because of the detailed pretest and pilot study conducted, which will guide the substantive investigation. This was an important aspect of the pretest and piloting phase since it allowed us to identify issues with the instruments' efficacy and the model transferability to the Malaysian private HLIs context. © 2022,International Journal of Technology. All Rights Reserved.

Key capabilities for frugal innovation in developed economies: insights into the current transition towards sustainability.

Frugal innovation has become a requirement for success in resource-scarce environments, a situation that the COVID-19 pandemic has exacerbated. In this context, the literature has developed several frugal innovation approaches for promoting sustainability, but there is no a widely accepted theory nor a predominant paradigm given the incipient and relatively new nature of a research domain that requires further studies. There is also a high potential for under-exploited markets, represented by low-income consumers who no longer concentrate on developing countries and where there is a cumulative number of consumers with minimal spending capacity, rising income distribution inequality, and the increasing polarization of wealth and risk of poverty. This paper contributes to the literature by examining from a Resource-Based View perspective, the critical role of two key organizational capabilities, namely market-focused learning and organizational ambidexterity, to develop firms' innovation capability in low-end markets due to the unique characteristics of these markets. In doing so, the study employs partial least squares structural equation modeling (PLS-SEM) with a sample of 190 manufacturing firms to provide empirical support to our theoretical predictions that establish that: (1) market-focused learning capability drives organizational ambidexterity, (2) market-focused learning capability and organizational ambidexterity foster organizational innovation capability, which, ultimately, affects cash flow, and (3) market-focused learning capability has a stronger effect on organizational innovation capability in low-end markets. Contrary to our expectations, organizational ambidexterity has a stronger impact on organizational innovation capability in non-low-end markets, considering that this is the first step to shed light on this issue.

Doing more with less - How frugal innovations can contribute to improving healthcare systems.

The dominance of an innovation discourse laden with cutting edge and expensive technologies, may be preventing us from recognizing alternative and complementary perspectives, which could help cut healthcare costs while improving worldwide access to health services. One such complementary approach is that of frugal innovation. Frugal innovation, as a way to produce efficacious and affordable products using fewer resources to reach the underserved customers, has received increasing attention in the social sciences literature. Although frugal innovation is commonly associated with emerging economies, there is now a rising interest from healthcare providers in developed countries, to find and apply effective, and lower-cost solutions. Nonetheless, knowledge on frugal innovation and its role in healthcare is dispersed across different literatures which hampers researchers and practitioners to access a fuller, and integrated picture of the phenomenon. In this study, by synthesizing extant knowledge, we tackle the fragmentation of the phenomenon. We elucidate on who the actors are, what is being done, how are such innovations being developed, and what the outcomes are, providing a framework that lays out the underlying mechanisms of frugal innovation in healthcare (FIH). The midrange theory that we develop, provides a conceptual framework for researchers to undertake empirical observation and models to guide managerial practices. Furthermore, by providing a more unified perspective of frugal innovation in healthcare, we hope to initiate conversations on the development, adequacy and adoption of these innovations in healthcare services, which could increase affordability and access for the population while maintaining quality.

An Innovative Telemedicine Initiative From Sri Lanka: The Value of Volunteerism in a Resource-Constrained Scenario During the COVID-19 Pandemic.

The unprecedented rise in COVID-19 cases in Sri Lanka since July 2021 led to a situation where the health system was getting overwhelmed. The priority shifted toward triaging patients and identifying those who need immediate medical intervention and managing the rest in home settings. An integrated patient management system where patients could access a medical professional through a short messages service (SMS) and calling system was established. This service provided telephone triage, patient advice, and coordinated with the national ambulance system to evacuate ill patients. This integrated helpline system had a major impact on the management of the recent surge of COVID-19 pandemic in Sri Lanka by patients needing urgent care were directed for hospitalization and the rest managed at home with support, reassurance, and guidance. The numbers of oxygen-dependent patients and deaths declined rapidly and the number of available beds increased. The system played a major role in bringing the crisis under control. Despite many challenges, this innovative integrated system is a unique example of medical volunteerism. The pandemic catalyzed the utilization of information and communication technologies effectively by providing healthcare with a reduction of the burden on healthcare institutions and professionals.

A disruptive model for delivering higher education programs within the context of entrepreneurship education

PurposeThe purpose of this practitioner paper is to explore whether the principles of Design Thinking and the Lean Startup could be employed in developing a disruptive model for delivering educational programs within higher education in a way that attempts to eliminate the multitude of problems facing this industry, while simultaneously adhering to the principles of frugal innovation and meeting relevant sustainability goals.Design/methodology/approachThe authors followed a design thinking approach, employing tools such as empathy mapping, customer journey, value proposition and semi-structured interviews to obtain a deep level of understanding of the problems educators and students within the context of entrepreneurship education are facing. Throughout the process they drew on the practice of emergent inquiry and customer co-creation to help guide decision making.FindingsThe authors successfully derived a conceptual solution in the form of a Minimum Viable Product of which the features were tested against the multitude of user needs and requirements. It was possible to demonstrate how the solution meets all nine of the requirements for frugal innovations while simultaneously adhering to applicable sustainability principles.Practical implicationsThe proposed solution offers a potential opportunity to first-movers in chosen academic disciplines to become leaders in online education.Originality/valueEven in an industry such as higher education there is a dire need for frugality and finding sustainable solutions for educators and students in both developed and developing markets. With this paper the authors succeed in presenting innovative combinations of digital artefacts, platforms and infrastructure to arrive at a novel crowd-sourced solution that is unique in its design.

The LeVe CPAP System for Oxygen-Efficient CPAP Respiratory Support: Development and Pilot Evaluation.

Background: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has placed a significant demand on healthcare providers (HCPs) to provide respiratory support for patients with moderate to severe symptoms. Continuous Positive Airway Pressure (CPAP) non-invasive ventilation can help patients with moderate symptoms to avoid the need for invasive ventilation in intensive care. However, existing CPAP systems can be complex (and thus expensive) or require high levels of oxygen, limiting their use in resource-stretched environments. Technical Development + Testing: The LeVe ("Light") CPAP system was developed using principles of frugal innovation to produce a solution of low complexity and high resource efficiency. The LeVe system exploits the air flow dynamics of electric fan blowers which are inherently suited to delivery of positive pressure at appropriate flow rates for CPAP. Laboratory evaluation demonstrated that performance of the LeVe system was equivalent to other commercially available systems used to deliver CPAP, achieving a 10 cm H2O target pressure within 2.4% RMS error and 50-70% FiO2 dependent with 10 L/min oxygen from a commercial concentrator. Pilot Evaluation: The LeVe CPAP system was tested to evaluate safety and acceptability in a group of ten healthy volunteers at Mengo Hospital in Kampala, Uganda. The study demonstrated that the system can be used safely without inducing hypoxia or hypercapnia and that its use was well-tolerated by users, with no adverse events reported. Conclusions: To provide respiratory support for the high patient numbers associated with the COVID-19 pandemic, healthcare providers require resource efficient solutions. We have shown that this can be achieved through frugal engineering of a CPAP ventilation system, in a system which is safe for use and well-tolerated in healthy volunteers. This approach may also benefit other respiratory conditions which often go unaddressed in Low and Middle Income Countries (LMICs) for want of context-appropriate technology designed for the limited oxygen resources available.

Frugal innovations: A multidisciplinary review & agenda for future research

Frugal innovation is about achieving more value while using fewer resources. This concept has found application across multiple domains, ranging from healthcare and transport to energy and manufacturing. This straddling of multidisciplinary domains fragments our academic understanding of the literature in this field. This state-of-the-art literature review, performed using multiple correspondence analyses across 199 articles, along with a Delphi study of prolific authors and practitioners working on frugal innovation, integrates multidisciplinary academic literature to offer a holistic picture of the current scholarly literature, outlining its key theoretical approaches and providing a glimpse of the future of the field. This study outlines the relevance of frugal innovations in combating the COVID-19 pandemic, establishing the key areas for future research in frugal innovation, such as new product development, ease of use, the performance of frugal innovations, strategy, and sustainability, among others.

Frugal manufacturing in smart factories for widespread sustainable development.

Manufacturing is a crucial activity of product development that feeds into and is also influenced by the design process. Any material conservation gained during manufacturing directly affects the green credentials of a product. Manufacturing waste can be contrived to approach zero through a recently developed frugal design approach that quantifies resource conservation at all stages of development of a product engineered for frugality. Accordingly, this effort presents frugal manufacturing (FM), integral to the frugal design approach, for utmost reduction of waste while aiming for good surface integrity, better properties, minimal number of processes and low cost. Other than saving on energy and hence emissions, the new concept of FM also goes beyond current near net shape technologies, which advocate mainly for zero wastage and suitable properties while using a narrow range of manufacturing processes. Case studies involving high-speed machining, superplastic forming and additive manufacturing of aerospace alloys have been presented that bring out the features and benefits of FM. As such the multipronged objectives of FM should be dovetailed with those of smart factories for creating novel technologies that abet widespread sustainable development. Such enhancement of the smart factories concept has been argued to support unusual applications such as the fight against pandemics including the current one involving COVID-19.

Design Thinking and Bricolage for Frugal Innovations during Crisis

The rapid spread of COVID-19has created resource-constraints. This study focuses on the application of design thinking in frugal innovations by social entrepreneurs to face the challenges during the COVID-19 pandemic. It discusses the case of an Indian social entrepreneur who essentially provides solutions for menstrual health and hygiene to unprivileged and rural women in India. When faced with the COVID-19 pandemic, the social entrepreneur re-purposed the manufacturing process and implemented bricolage to produce masks which were the need of the hour. The manufacture of masks was a frugal innovation due to the resource constraints during the pandemic. The research paper is qualitative, and it follows an inductive case study approach. The implementation of design thinking in frugally innovating is established through the content analysis of the interviews of the social entrepreneur and her team members. It presents practical implications of design-thinking for frugal innovations by social entrepreneurs in adversity.

Continuous positive airway pressure for respiratory support during COVID-19 pandemic: a frugal approach from bench to bedside.

BACKGROUND: We describe a frugal approach (focusing on needs, performance, and costs) to manage a massive influx of COVID-19 patients with acute hypoxemic respiratory failure (AHRF) using the Boussignac valve protected by a filter ("Filter Frugal CPAP", FF-CPAP) in and out the ICU. METHODS: (1) A bench study measured the impact of two filters with different mechanical properties on CPAP performances, and pressures were also measured in patients. (2) Non-ICU healthcare staff working in COVID-19 intermediate care units were trained with a video tutorial posted on a massive open online course. (3) A clinical study assessed the feasibility and safety of using FF-CPAP to maintain oxygenation and manage patients out of the ICU during a massive outbreak. RESULTS: Bench assessments showed that adding a filter did not affect the effective pressure delivered to the patient. The resistive load induced by the filter variably increased the simulated patient's work of breathing (6-34%) needed to sustain the tidal volume, depending on the filter's resistance, respiratory mechanics and basal inspiratory effort. In patients, FF-CPAP achieved pressures similar to those obtained on the bench. The massive training tool provided precious information on the use of Boussignac FF-CPAP on COVID-19 patients. Then 85 COVID-19 patients with ICU admission criteria over a 1-month period were studied upon FF-CPAP initiation for AHRF. FF-CPAP significantly decreased respiratory rate and increased SpO2. Thirty-six (43%) patients presented with respiratory indications for intubation prior to FF-CPAP initiation, and 13 (36%) of them improved without intubation. Overall, 31 patients (36%) improved with FF-CPAP alone and 17 patients (20%) did not require ICU admission. Patients with a respiratory rate > 32 breaths/min upon FF-CPAP initiation had a higher cumulative probability of intubation (p < 0.001 by log-rank test). CONCLUSION: Adding a filter to the Boussignac valve does not affect the delivered pressure but may variably increase the resistive load depending on the filter used. Clinical assessment suggests that FF-CPAP is a frugal solution to provide a ventilatory support and improve oxygenation to numerous patients suffering from AHRF in the context of a massive outbreak.

Breaking the chain: Governmental frugal innovation in Kerala to combat the COVID-19 pandemic.

As the COVID-19 pandemic causes unprecedented disruptions in citizens' lives and work, prompting a wide range of responses from governments across the globe. The southern Indian state of Kerala, India's COVID-19 "ground zero", stands out with a fatality rate at a fraction of other richer Indian states and countries. This has happened despite the state presenting strong vulnerabilities to COVID-19. Using the theoretical lens of frugal innovation, I analyse how the Kerala State Government (KSG) combated the spread of COVID-19. This research uncovers the mechanisms at play as KSG implemented and used frugal technologies as platforms that helped decision making and strategy to fight the pandemic. I find a rich interplay of frugal innovations promoted by the government, in partnership with research institutes and private sector actors, which are cheap and efficacious. The study defines and promotes the concept of government frugal innovation (GFI) and provides valuable insights and tools to help governments navigate and effectively respond to this crisis, encouraging the rest of the world to learn from Kerala's experience. My conceptual model characterizes GFI as involving collaborative aspects, and holds practical implications beyond the times of crises.

COVID-19 pandemic and total knee arthroplasty: the concept of a containment sheet-a frugal innovation.

BACKGROUND: 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). MATERIAL AND METHOD: 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 p < 0.05 levels. RESULTS: 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 (p < 0.05). Face shield showed significant number of aerosols/splatters in control group. Highest number/concentration of aerosols/splatters was contained within the sheet. CONCLUSION: 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.