Hand-arm vibration in orthopaedic surgery: a neglected risk

Area of Science:

• Occupational Health
• Biomechanics
• Surgical Technology

Background:

• Hand-arm vibration syndrome (HAVS) is a significant occupational disease resulting from exposure to hand-arm transmitted vibration.
• Regulatory bodies like the Health and Safety Executive have established exposure action values (EAV) and exposure limit values (ELV) to mitigate risks associated with vibration exposure.

Purpose of the Study:

• To quantify hand-arm transmitted vibration experienced by orthopaedic surgeons during surgical procedures.
• Specifically, to measure vibration levels during tibial cuts performed with battery-operated saws.

Main Methods:

• A cadaveric study was conducted involving three surgeons performing tibial cuts using battery-operated saws.
• Vibration measurements utilized frequency-weighted root mean square acceleration, with the vibration total value calculated across three axes.

Main Results:

• The mean vibration magnitude observed was 1 m/s2 (X-axis), 10.3 m/s2 (Y-axis), and 4.2 m/s2 (Z-axis).
• The weighted root mean squared magnitude of vibration was 11.3 m/s2.
• These levels suggest an EAV of 23 minutes and an ELV of 1 hour and 33 minutes for the equipment used.

Conclusions:

• Battery-operated sagittal saws can transmit hand-arm vibration levels that approach regulatory limits (EAV/ELV) with prolonged use.
• Further research is required to fully assess the risk and determine the necessity of surveillance for orthopaedic surgeons regarding vibration exposure.