A scrub tech is the person in the operating room who keeps your surgery clean, organized, and moving. You will probably never learn their name. After more than twenty years and more than 700 joint replacements a year, I can tell you that a great scrub tech is one of the biggest reasons a hip or knee replacement goes smoothly.
The scrub tech is usually already gowned and gloved at the back table when you roll in. Here is what that person does, and why I care so much about who stands across from me.
What Does a Scrub Tech Do in the Operating Room?
A scrub tech prepares, protects, and manages everything sterile during your operation. That includes the instruments, the implants, the drapes, and the germ-free zone around your incision called the sterile field.
They set up the room before you arrive, hand me instruments during the case, count every sponge and needle, and help finish the operation. The U.S. Bureau of Labor Statistics lists the same core duties: prepare the room, keep supplies sterile, pass instruments, and count items so nothing is left behind.
Is a scrub tech the same as a surgical technologist?
Yes. Scrub tech, surg tech, surgical tech, and operating room technician all describe the same job. The formal title is surgical technologist.
The word “scrub” comes from the careful hand and arm scrub they do before putting on a sterile gown and gloves.
Who Is in the Operating Room During Hip or Knee Replacement?
Most patients see six to eight people in masks and caps when they roll into the room for a joint replacement. Each person has a set job. This table shows who is who.
| Team member | Sterile or non-sterile | Main job during your surgery |
|---|---|---|
| Orthopaedic surgeon | Sterile | Performs the operation and leads the team |
| Scrub tech (surgical technologist) | Sterile | Builds and guards the sterile field, passes instruments, prepares implants, counts supplies |
| Surgical first assistant or physician assistant | Sterile | Works at the incision with the surgeon: holds retractors, uses suction, helps close |
| Circulating nurse (RN) | Non-sterile | Checks you in, leads the safety time-out, opens supplies onto the field, charts, counts with the scrub tech |
| Anesthesiologist or nurse anesthetist | Non-sterile | Manages anesthesia, breathing, blood pressure, and pain control |
| Implant or robotic product specialist | Non-sterile | Confirms implant inventory and supports the robotic software; never touches the patient |
The key divide is sterile versus non-sterile. Sterile team members wear gowns and gloves and can touch the field. Non-sterile members cannot, so they rely on the scrub tech and circulating nurse to pass items in safely.
What Does a Scrub Tech Do Before, During, and After Surgery?
The job starts well before your incision and ends after your bandage goes on. Here is how the work breaks down on a typical hip or knee replacement day.
| Phase | What the scrub tech does |
|---|---|
| Before you enter the room | Scrubs in, opens sterile instrument trays, builds the back table, checks that every tool works, and does the first count with the circulating nurse |
| As surgery starts | Helps drape you, joins the safety time-out, and hands up the first instruments |
| During surgery | Passes instruments, assembles saws and drills, prepares trial and final implants, mixes bone cement when used, and watches for any break in sterility |
| Before closing | Leads the closing count of sponges, needles, and instruments |
| After surgery | Applies the dressing, breaks down the field, sends instruments for cleaning and sterilization, and resets the room |
For an instrument-heavy case like a total knee replacement, setup alone can take 15 to 45 minutes. The time depends on the implant system, whether a robot is used, and how experienced the team is.
Why Is the Scrub Tech So Important in Knee and Hip Replacement?
Joint replacement is one of the most instrument-heavy operations in medicine, with large trays of tools, powered saws, and many trial implant sizes. Here are the five jobs I count on my scrub tech to do well every time.
- Guard the sterile field. Only sterile items touch the field. The scrub tech sets it up, watches it, and rebuilds it if anything is contaminated.
- Stay one step ahead. The best scrub techs know the order of the operation. When I finish one step, the tool for the next step is already in my hand, which saves time under anesthesia and keeps my attention on you.
- Keep the count. Sponges, needles, blades, and instruments are counted with the circulating nurse before surgery, before closing, and at the end. This is how teams make sure nothing is left inside a patient.
- Handle implants and cement correctly. Before any implant is opened, the team confirms the side, size, and type out loud. When a part is cemented, the scrub tech mixes and times the bone cement so it sets properly.
- Assemble the power tools. Hip and knee replacement uses bone saws, drills, reamers (tools that shape the hip socket), and broaches (tools that shape the thigh bone for the hip stem). Each one has to be put together correctly and handed up ready to use.
How does a scrub tech help with robotic knee and hip replacement?
Many of my hip and knee replacements use the Mako® robotic-arm system made by Stryker®. (Disclosure: I am a paid consultant for Stryker.) The scrub tech covers the robotic arm in sterile drapes, attaches the saw or reamer, and helps manage the small tracking markers that let the system follow your bones in real time.
The robot does not replace the team. It adds steps, and a scrub tech who knows those steps keeps a robotic case as smooth as a manual one. You can read more on my robotic joint replacement page and in my post on how tracking arrays work.
How does the scrub tech protect you from infection?
Infection after joint replacement is uncommon, but it is one of the problems we work hardest to prevent. The scrub tech watches every glove, drape, and instrument and speaks up the moment something is off.
If a glove tears, a fresh pair is often opened before I even notice. I double glove for the same reason, and I explain how that works in my post on indicator gloves.
Why do team safety checks matter so much?
Surgical teams that talk to each other have fewer complications. In a landmark 2009 study of surgical patients at eight hospitals worldwide, a team safety checklist lowered deaths from 1.5 percent to 0.8 percent and complications from 11 percent to 7 percent. The scrub tech takes part in every one of those checks.
Why Would My Surgery Be Delayed for a Sterility Problem?
A delay for a sterility problem means your team is doing its job. If a sterile wrapper has a small hole, gets wet, or touches something non-sterile, that equipment is no longer safe to use.
Sometimes the fix is quick: open a new instrument. If a key tray has to be cleaned and sterilized again, the wait can stretch past an hour.
Here’s what I tell my patients: I would much rather start late than start with anything less than sterile equipment.
How Does a Scrub Tech Get Trained and Certified?
Most scrub techs complete a surgical technology certificate or an associate degree, which takes about 12 months to 2 years. Programs cover anatomy, microbiology, and sterile technique, plus clinical rotations in real operating rooms.
Many then earn the Certified Surgical Technologist (CST) credential by passing a national exam from the National Board of Surgical Technology and Surgical Assisting.
Is there a shortage of scrub techs?
Demand is steady and growing. The Bureau of Labor Statistics projects surgical technologist jobs to grow about 5 percent from 2025 to 2035, faster than average, with about 8,600 openings a year for surgical assistants and technologists combined.
Surgery centers drive much of that growth as more joint replacements move to outpatient surgery. A new scrub tech can be excellent, but learning a surgeon’s steps takes time, which is why I value teams that stay together.
What Should Patients in Franklin and Middle Tennessee Know About Their Surgical Team?
You are choosing a surgeon, but you are also getting a team. At the Bone and Joint Institute of Tennessee in Franklin, I work with scrub techs, nurses, and anesthesia providers who do hip and knee replacement day after day.
Patients come to us from Nashville, Brentwood, Columbia, and across Middle Tennessee. It is fair to ask any surgeon how often their team performs your procedure, because repetition is what makes a room safe and efficient.
If hip or knee pain is limiting your life, schedule a consultation or call (615) 791-2630.
We are at the Bone and Joint Institute of Tennessee, 3000 Edward Curd Lane, Franklin, TN 37067. You can also learn more about total knee replacement, total hip replacement, and anesthesia for joint replacement.
Watch: Scrub Techs Do More Than Pass Instruments
In this short video, I share the moment a new PA realized my scrub tech knew the case as well as I did, and why that matters for your safety in hip and knee replacement.
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Medical disclaimer: This article is for educational purposes only and does not replace professional medical advice. Talk with a qualified orthopaedic surgeon about your own situation.
References
- Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360(5):491-499. doi:10.1056/NEJMsa0810119
- US Bureau of Labor Statistics. Occupational Outlook Handbook: Surgical Assistants and Technologists. Updated August 27, 2026. https://www.bls.gov/ooh/healthcare/surgical-technologists.htm
