Abstract
Abstract
Objectives
Total hip arthroplasty (THA) procedures are physically demanding for surgeons. Repetitive mallet swings to impact a surgical handle (impactions), can lead to muscle fatigue, discomfort and injuries. The use of an automated surgical hammer may reduce fatigue and increase surgical efficiency. The aim of this study was to develop a method to quantify user's performance, by recording surface electromyography (sEMG), for automated and manual impactions.
Methods
sEMG signals were recorded from eight muscle compartments (arm and back muscles) of an orthopaedic surgeon during repetitions of manual and automated impaction tasks, replicating femoral canal preparation (broaching) during a THA. Each task was repeated, randomly, four times manually and four times with the automated impaction device. The mechanical outcomes (broaching efficiency and broach advancement) were quantified by tracking the kinematics of the surgical instrumentation. Root mean square (RMS) values and median frequency (MDF) were calculated for each task to, respectively, investigate which muscles were mostly involved (higher RMS) in each task and to quantify the decrease in MDF, which is an indicator of muscle fatigue.
Results
RMS for arm muscles was significantly higher (p-value=0.002) during manual impactions than during automated impactions and muscle fatigue was significantly reduced (p-value=0.011), for the same muscles, when the same tasks were performed with the automated surgical hammer. The time required to achieve the same mechanical outcome, in terms of broaching efficiency and broach advancement, was significantly reduced with the automated surgical hammer (p=0.019).
Conclusions
Results from this study showed how with this methodology it was possible to discern muscle performance and fatigue, between impaction modalities. Moreover, the reduction in exposure time to automated impactions, could be a factor in muscle fatigue decrease. These results could therefore provide useful insights into the study of surgical ergonomic improvements, to reduce surgeons muscle fatigue and, potentially, injuries.
Declaration of Interest
(a) fully declare any financial or other potential conflict of interest
