Does the amount of noise generated differ between manual and robotic TJA?

The purpose of this study was to evaluate whether noise that is generated during manual and robotic-assisted total joint arthroplasty (TJA) differs and if that noise exceeds the Occupational Safety Health Administration (OSHA) action limits.

Personal dosimeters were used to record the decibel (dB) level during manual and robotic-assisted total hip and knee arthroplasty (THA/TKA). The primary surgeon wore the dosimeter on their person. All robotic procedures were performed with the use of image-based robotic arm aided technique. Peak decibel levels (LCPeak) and continuous decibel levels (LAeq) were captured in each procedure. 2-tailed student T-test was calculated to evaluate a difference between LAeq and LCPeak values between groups. An exposure calculator was used to calculate the 8-h Time-Weighted-Average (TWA).

A total of 40 procedures were recorded; 10 for each robotic and manual THA and TKA. The mean LAeq dB levels for the robotic THA and TKA were 71.4 (SD 1.9) and 69.7 (SD 2.3) dB, and for manual THA and TKA levels were 69.8 (SD 2.4) and 71.3 (SD 2.4) dB. The max LCPeak decibel in each group did not exceed the OSHA peak sound pressure limit. Average LCPeak values in manual THA were higher than robotic THA (P = 0.01). Manual and robotic TKA values showed no difference. No groups exceeded the 8-h TWA limit.

TJA surgeons have significant noise exposure during surgery regardless of surgical technique; however, peak sound pressures and 8-h TWA dB levels discovered during mTJA and rTJA did not exceed OSHA limits.