Ergonomics in the Operating Room: Recommendations for Orthopaedic Surgeons

Orthopaedic surgeons face notable occupational hazards, including suboptimal ergonomics in the operating room (OR). This results in high rates of musculoskeletal injuries that affect at least four in 10 orthopaedic surgeons. Sex disparities exacerbate these issues, with female surgeons reporting markedly higher rates of occupational injuries and discomfort with surgical instrument use compared with male surgeons. Factors such as sustained nonergonomic positions, poor instrument design, improper OR setups, and forceful and repetitive movements contribute to these injuries. With upward of one in three injured orthopaedic surgeons taking leaves, modifying their practices, or retiring prematurely, there is a need to safeguard the health and longevity of the orthopaedic workforce. Surgeons can mitigate the risk of musculoskeletal injuries by maintaining neutral body positions, adjusting their OR environment (e.g., table height), and incorporating brief interventions (e.g., position changes and regular microbreaks). Educating surgeons on these interventions is important for reducing harm. Institutions can consider adapting policies and conducting research focused on enhancing ergonomics to further contribute to creating safer surgical environments. Improving OR ergonomics not only influences orthopaedic surgeon well-being and practice longevity but also enhances patient care and reduces the economic toll of occupational injuries.