Intraoperative Acoustics: Auditory Cues in Hip Reconstructive Surgery.

Area of Science:

• Orthopaedic Surgery
• Bioacoustics
• Surgical Technology

Background:

• Orthopaedic surgeons primarily rely on visual and tactile feedback in the operating room (OR).
• Limited data exists on how sound changes during orthopaedic procedures and its use as auditory feedback.
• This study investigates meaningful sound alterations during critical stages of total hip arthroplasty (THA).

Purpose of the Study:

• To define and analyze significant sound changes during key steps of total hip arthroplasty (THA).
• To assess the detectability of these sound changes by the human ear.
• To explore the potential of audio feedback in enhancing surgical performance during THA.

Main Methods:

• Acquired 84 audio recordings during primary elective THA procedures.
• Focused on critical tasks: femoral neck sawing, acetabular reaming, cup impaction, liner impaction, femoral broaching, calcar planing, and stem insertion.
• Analyzed frequency intensity changes across the human hearing spectrum and identified statistically significant temporal variations.

Main Results:

• Significant increases in sound intensity were observed during femoral neck sawing, polyethylene liner impaction, and stem insertion.
• A significant decrease in sound intensity was noted during calcar planing.
• Characteristic frequencies with maximal loudness changes, detectable by the human ear, were identified for critical THA tasks.

Conclusions:

• Reproducible and detectable sound changes occur during total hip arthroplasty (THA).
• Auditory feedback can be integrated by surgeons to guide performance and optimize outcomes in the OR.
• Findings suggest broader applicability to other orthopaedic procedures and highlight the need to minimize ambient OR noise.