What factors influence surgeon cervical posture and perceived workload during TKA?

3 pages•Published: October 26, 2019

Laura Scholl, Frank Kolisek, Antonia Chen, Anil Bhave, Adam Freedhand, Emily Hampp, Vincent Alipit and Michael Mont

Abstract

Orthopaedic surgery is a mentally and physically demanding procedure for surgeons. Studies reported 44-66% of surgeons surveyed have had a work-related injury attributed to poor surgeon posture. The purpose of this study was to understand how surgical variables may affect a surgeon’s posture and workload when performing TKA. Variables included: influence of level of surgical experience, type of surgical procedure, and specific surgical tasks.
Two experienced surgeons, with a median 22-years surgical experience, and 2 surgeons, currently in their fellowship training, each performed 3 manual TKAs (MTKA) and 3 robotic assisted TKAs (RATKA) using a cadaveric setup. Kinematic sensors were placed on the occiput and T3 to measure flexion of the head and neck. Surgeons were surveyed to assess their physical and mental effort using a 1-10 scale (1 being least effort).
Compared to the fellows, experienced surgeons had reduced occiput and T3 angles for MTKA (28.0 vs. 38.7°, 4.2 vs. 15.7°) and RATKA (18.0 vs. 29.2°, 4.8 vs. 13.2°) as well as reduced mental and physical effort. Considering surgical procedure, all surgeons had reduced occiput angles for RATKA compared to MTKA. Considering surgical task, surgical application (MTKA vs. RATKA) had greater influence on cervical angles for the fellows group.
All three factors influenced the surgeon’s posture and workload. Occiput angle was reduced by approximately 10° during RATKA, which is attributed to the surgeon standing in a more upright position, to visualize the robotic screen during cutting and trialing. Robotics may help newer surgeons better visualize knee balancing during TKA, easing the process of balancing and trialing.

Keyphrases: robotic assisted tka, surgeon ergonomics, surgeon experience, total knee arthroplasty

In: Patrick Meere and Ferdinando Rodriguez Y Baena (editors). CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 3, pages 331-333.

Links:	https://easychair.org/publications/paper/VPSS
	https://doi.org/10.29007/vnn2

BibTeX entry

@inproceedings{CAOS2019:What_factors_influence_surgeon,
  author    = {Laura Scholl and Frank Kolisek and Antonia Chen and Anil Bhave and Adam Freedhand and Emily Hampp and Vincent Alipit and Michael Mont},
  title     = {What factors influence surgeon cervical posture and perceived workload during TKA?},
  booktitle = {CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Patrick Meere and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {3},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/VPSS},
  doi       = {10.29007/vnn2},
  pages     = {331-333},
  year      = {2019}}

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