Operating Table Height Optimization Reduces Surgeon Postural Load During Total Knee Arthroplasty: An Ergonomic...

Area of Science:

• Orthopaedic Surgery
• Ergonomics
• Occupational Health

Background:

• Work-related musculoskeletal disorders (WMSDs) are common among orthopaedic surgeons due to prolonged non-neutral postures and forceful tasks.
• Working height is crucial for surgeon posture, but ergonomic recommendations are under-evaluated in orthopaedic surgery.

Purpose of the Study:

• To systematically evaluate the impact of adjusted working height on surgeon posture during total knee arthroplasty (TKA).
• To assess the effectiveness of Canadian Centre for Occupational Health and Safety (CCOHS) recommendations for surgical working height.

Main Methods:

• A simulated TKA was analyzed across four surgeon positions and two working height conditions (uncorrected vs. CCOHS-corrected).
• Joint angles were measured from photographs, and postural load was quantified using the Rapid Entire Body Assessment (REBA) method.
• 288 REBA scores were collected from three independent assessments by two trained evaluators.

Main Results:

• Ergonomic working height correction significantly reduced mean REBA scores across all surgeon positions (p < 0.001).
• The average reduction in postural load was 0.92 REBA points, with notable improvements during bone cutting, drilling, and impaction.
• 27 out of 48 position-step comparisons exceeded the minimal detectable change threshold for improvement.

Conclusions:

• Adjusting working height based on CCOHS guidelines effectively lowers surgeon postural load during TKA.
• Implementing evidence-based ergonomic adjustments is recommended for routine orthopaedic surgical practice to mitigate WMSDs.